If you have diabetes, taking good care of your feet is critical to staying healthy. Diabetes can cause you to lose sensation in your feet, and you may not realize it when you experience a foot injury. This is due to the high levels of blood glucose found in these patients, which can lead to damaged nerves.
Blood vessels are also frequently damaged from diabetes, which results in poor circulation (peripheral artery disease, or PAD). Without proper circulation, the feet do not get enough blood, which makes it harder for wounds to heal. All of this can cause serious foot problems categorized as having "diabetic foot," including:
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Diabetic foot ulcers (wounds that do not heal)
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Skin or bone infections
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Gangrene (dead tissue caused by loss of circulation)
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Charcot foot (fractures and severe deformities)
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Non-healing surgical wounds
In severe cases, this type of foot condition can lead to infections and other complications that may require limb-saving surgery. At MedStar Health's Wound Healing Institute, our diabetic limb specialists offer the most advanced prevention and treatment options.
Symptoms, causes, and risk factors
Over time, the high levels of blood glucose found in diabetic patients can lead to damaged nerves. Unable to feel sensations in their feet, patients can develop cuts, blisters, or sores that, untreated, become ulcers and severe infections. Blood vessels are also frequently damaged from diabetes. Without proper circulation, feet do not get enough blood circulating, which makes it harder for wounds to heal. As a result, patients with diabetes and foot infections may be at risk for limb loss.
The first sign of a diabetic foot problem is often inflammation. Eventually, the shape of the foot may become fractured and deformed. It can also cause:
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Foot and nerve pain
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Difficulty wearing shoes
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Skin dryness and breakdown
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Non-healing ulcers, and
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Infections
If you have diabetes and notice any of the above signs and symptoms, make an appointment with the MedStar Health Wound Healing Institute to have your feet examined right away.
Foot care and limb loss prevention
If you have diabetes, it’s important to keep your blood sugar under control and maintain good diabetic foot care. You should also follow a healthy diet to ensure your body gets the necessary nutrition it needs to promote wound healing. To help you prevent a foot ulcer, ask your doctor about our diabetes education program. You may also benefit from yearly foot screenings through our Wound Healing Institute to monitor your risk of a severe foot infection.
What can I do to take care of my feet?
You may lower your risk for infection with these hygiene tips from the National Institute of Diabetes and Digestive and Kidney Diseases:
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Check your feet every day
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Wash your feet every day
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Keep the skin soft and smooth
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Smooth corns and calluses gently
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Trim your toenails regularly if you can see, reach, and feel your feet. If you cannot, ask a foot doctor (podiatrist) to trim them for you.
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Wear well-fitting or specialized shoes and socks at all times
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Protect your feet from hot and cold
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Keep the blood flowing to your feet
Complications can worsen quickly, so talk to your doctor immediately if you notice any signs or symptoms.
Treatment
When you have a diabetic foot ulcer or infection that won't heal, our primary goal is addressing the root cause and preventing lower limb amputations. To do this, we work together with the experts you need, including:
This team approach allows us to create a treatment plan that will manage your condition most effectively and gives you access to a full spectrum of diabetic wound services including:
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Debridement, which is the medical removal of damaged or infected tissue to improve the healing ability of remaining tissue
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Diabetic orthotics, or specialized, prescription footwear designed to reduce the risk of wounds or injuries as a result of diabetic neuropathy (nerve damage)
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Foot and ankle reconstructive surgery, which corrects the structures of the foot to restore function
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Gait evaluation, which analyzes how you stand or walk to detect areas of pressure and potential ulceration
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Hyperbaric oxygen therapy (HBOT), which delivers oxygen to the wound by breathing 100 percent oxygen in a special chamber, increasing blood flow to affected areas to heal your wounds faster.
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Prosthetic devices, which improve mobility with an artificial limb in cases when an arm or other extremity is amputated or lost
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Total contact casting, which involves fitting a non-removable cast to protect the affected limb
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Wound care services, which includes the latest advances in therapeutic and surgical techniques to promote complete healing
Limb salvage or limb-saving treatments
Limb-saving surgery makes it possible to treat the most serious cases by reconstructing a functional limb. The goal of treatment is to prevent limb loss and preserve limb function so you can keep moving and doing the things you enjoy.
These experts in our Vascular and Endovascular Program and our Wound Healing Institute work together to offer the most current minimally invasive treatments for limb salvage. Your care team may include a podiatrist specializing in foot and ankle surgery, as well as a vascular surgeon, and/or a plastic and reconstructive surgeon. Our team’s expertise means we can save patients’ feet and legs when traditional therapies fail. We offer a number of treatment options to improve blood flow and reduce the risk of diabetic amputations, including:
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Angioplasty, which allows us to push plaque blockages against the walls of an artery
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Atherectomy, where we cut plaque out of a narrowed artery
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Stenting, during which we implant a small, expandable tube called a stent in the narrowed artery to help it stay open and enable normal blood flow
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Bypass, using a vein or synthetic tube to bypass the area of blockage and carry blood to the area of need
Recovery
Recovery from diabetic limb salvage surgery may take some time. You will need to stay off your feet immediately after surgery. Then, you will likely need to wear special braces and shoes to cushion your feet as they continue to heal. We may also recommend physical therapy to help you regain strength in your feet. Your surgeon will discuss the specific details of your recovery with you before your procedure.
Our providers
Expert wound care
Getting the care you need starts with seeing one of our wound care specialists.
Our locations
Distance from Change locationEnter your location
MedStar Health: Plastic Surgery at MedStar Georgetown University Hospital
3800 Reservoir Road NW, BLES Building 1st. Floor Washington, D.C., 20007
866-990-5515
Frequently asked questions
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What is charcot foot?
Charcot foot is a progressive disease where the bones in the foot or ankle joints deteriorate and weaken. Having diabetic neuropathy can put you at risk for Charcot foot because it decreases the sensation in your feet. In severe cases, the foot may take an abnormal shape due to a collapse of the midfoot arch.
Non-surgical treatment of Charcot foot may involve wearing a special boot, custom shoes, or bracing to immobilize and protect the foot. In some cases, the deformity is severe enough to warrant surgical correction. A single procedure may be all that is needed to alleviate pressure points. For the most complex cases, reconstructive foot and ankle surgery may be required to realign and fuse the bones in the proper position.
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What is peripheral vascular disease?
People with peripheral artery disease (PAD) have reduced blood flow to their limbs, especially the legs. This is caused by atherosclerosis, a narrowing of the arteries caused by fatty deposits called plaque. Over time, this can progress to critical limb ischemia (CLI), which can cause severe leg or foot pain, slow-healing sores, or even gangrene.
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How can I avoid amputation?
Diabetes causes problems with sensation in the feet, which leaves patients susceptible to foot injuries that can go undetected long enough to become severely infected. That's why it's critical to check your feet daily if you are a diabetic patient and talk to your doctor immediately if you notice a change in your feet. The earlier we can intervene, the better your chances are of receiving effective treatment before a wound or severe infection develops.
You can also lower your risk of amputation by managing your sugar levels and staying in close communication with your primary care doctor or endocrinologist. If a wound develops, they can help train you to care for it properly to ensure healing.
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When is amputation the best treatment option?
While there are many treatment options available that may save feet and legs, sometimes amputation is necessary. Amputations due to diabetes can range from removing a toe to removing a large portion of the leg to prevent a life-threatening wound or infection.
The choice to have an amputation is a difficult one, and your care team will walk alongside you as you process your options. For patients who would benefit from an amputation, we offer comprehensive services, including prosthetics, rehabilitation, and counseling services to help you adjust and return to the things you love.
Patient resources
Contact us
To learn more or schedule an appointment, call 888-83-WOUND.