Diabetes that is not well controlled leads to ulcers in the foot called diabetic foot ulcers. In this condition, the skin tissue breaks down and the skin underneath is exposed. The big toes in the legs and the balls of the feet are the most affected body parts. They go to an extent of affecting the bones too. Uncontrolled diabetes leads to this condition, though regular cleansing of the feet and taking good care of the feet can help prevent diabetic foot ulcers. Infected ulcers even lead to the amputation of the leg if neglected.
What are the Symptoms of Diabetic Foot Ulcers
There are a lot of symptoms that indicate diabetic foot ulcers. Few of them are as follows:
- Fluid comes out of the foot, thereby staining the socks or leaking out of the shoes
- There is swelling, redness, irritation, and bad odor from one or both feet
- Growth of a black tissue called eschar surrounds the ulcer due to the absence of proper blood flow to the ulcer
- Partial or complete gangrene around the ulcers appears resulting due to tissue death or infections
What are the Causes of Diabetic Foot Ulcers
Diabetic foot ulcers are caused by the following:
- Poor blood circulation: It is a vascular disease in which blood does not flow normally to the tissues and the ulcers do not heal because of poor blood supply.
- High blood sugar or hyperglycemia
- Nerve damage: A nerve in the foot if affected can lead to long-term loss of feeling in the foot. There is a tingling and painful feeling at first
- Wounded feet: Sensitivity to foot pain is reduced because of nerve damage. This leads to painless wounds causing ulcers.
- Poor hygiene of the foot
- Use of tobacco which inhibits blood circulation
Pathophysiology of Diabetic Foot Ulcers
The physiology of diabetic ulcers show autonomic dysfunction resulting in the drying of skin as the normal glandular function is lost. This leads to increased mechanical and axial stress on the skin. This makes it more prone to injury due to drying. Peripheral vascular disease causes more than 60% of the diabetic ulcers due to decreased blood flow. High osteomyelitis is propotional to the severity of diabetic foot ulcers.
How is Diabetic Foot Ulcers Treated
Treatment of diabetic foot ulcers involve controlled blood sugar levels. Since there is no cure for diabetes, foot ulcers can be prevented but there is no cure unless the blood sugar levels are taken care of. Off-loading prevents pain and ulcers. Antibiotics, antiplatelets, or anti-clotting medications may be used. In severe cases, foot amputation is recommended. Walking and stressing the foot are the best treatment options, but walking is recommended to treat diabetes. Diabetic shoes, compression wraps, and shoe inserts to prevent corns and calluses are some preventive measures.
Stem Cells therapy for Diabetic Foot Ulcers
Mesenchymal stem cells (MSCs) are the most efficient in cell therapy for patients with diabetic foot ulcers. MSCs have immunosuppressive properties. Moreover, umbilical cord derived MSCs (UC-MSCs) have been successfully used to treat patients with diabetic foot ulcers. MSCs showed the ability to regrow the damaged skin in the affected foot.