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What is a diabetic foot ulcer?

A diabetic foot ulcer is a common yet major complication of uncontrolled diabetes mellitus. Normally, healing of a wound is a stepwise process of repairing the lost extracellular matrix. However, some disorders interrupt this normal process of healing. This leads to prolonged healing of the wound. Diabetes mellitus is one such disorder that interferes with the healing process by delaying the formation of healthy granulation (regeneration) tissue.

What are its main signs and symptoms?

Diabetic foot ulcer may not always be painful. If the nerves involved are not damaged, then there the person would experience pain. Since it is a serious condition, it should be treated immediately. A diabetic ulcer looks like a red crater with a border of thickened skin. In severe cases, this red crater goes very deep, involving the underlying tendons, and bone. There may be swelling, heat, and pain due to inflammation. In late stages, discharges, foul odour, and discoloured granulation tissue are seen.

What are its main causes?

Diabetic foot ulcer is most commonly seen in patients who use insulin. Being overweight, tobacco use and alcohol intake are risk factors that worsen diabetic ulcer. Sometimes, you may not notice the ulcer due to loss of sensation in that area. Poor blood circulation further aggravates the condition by interfering with the repair.

It begins as a small ulcer, which usually goes unnoticed due to lack of sensation, and develops to form a deep diabetic ulcer. If left untreated for long, infection of the ulcer may set in and result in pus (abscess) formation. This abscess can lead to infection of bone called osteomyelitis. Further delay in treatment can cause gangrene of the affected area, which means the foot might have to be amputated.

How is it diagnosed and treated?

Generally, doctors diagnose diabetic foot ulcer by examining the wound. Your doctor will check your blood sugar levels and your walking pattern to check for pressure points on your foot, reflexes and also test the sensation in the feet.

Your doctor may advise the following tests:                  

  • Blood tests
  • Wound culture
  • MRI and CT scan
  • X-ray

Strict control of blood sugar levels is the first step in promoting healing of the foot ulcer.  The main aim in the treatment of foot ulcer is to promote healing as early as possible, so that the chances of wound infection are reduced.  Using various methods, the pressure over these ulcers is relieved and the dead tissues are removed. The wound should be kept covered to prevent infection of the ulcer.

Other methods of treating diabetic foot ulcer are:

  • Hyperbaric oxygen therapy
  • Negative pressure wound therapy
  • Revascularisation of the debrided area
  • Ozone therapy
  • Loading off of pressure
  • Medications like antibiotics to control infection.

 

  1. Medicines for Diabetic Foot Ulcer

Medicines for Diabetic Foot Ulcer

Medicines listed below are available for Diabetic Foot Ulcer. Please note that you should not take any medicines without doctor consultation. Taking any medicine without doctor's consultation can cause serious problems.

Medicine NamePack SizePrice (Rs.)
MagnexMAGNEX 2GM INJECTION721
Monocef SbMONOCEF-SB 500MG/250MG INJECTION48
ZostumZostum 1000 Mg/500 Mg Injection248
Stafcure LzStafcure Lz Tablet277
MilibactMilibact 1000 Mg/500 Mg Injection124
LizolidLIZOLID I.V 300ML334
Clenol LbClenol Lb 100 Mg/100 Mg Tablet55
Cefopam SCefopam S 500 Mg/500 Mg Injection96
DalcapDalcap 150 Mg Capsule76
CefortalCefortal 500 Mg/500 Mg Injection112
Nilac(Sou)Nilac Tablet11
Imidil C VagImidil C Vag Suppository59
CefosealCefoseal 500 Mg/500 Mg Injection95
UniclidUniclid 300 Mg Tablet144
Tinilact ClTinilact Cl Soft Gelatin Capsule135
Cefpar SbCefpar Sb 1000 Mg/1000 Mg Injection267
Clindamycin 300 Mg InjectionClindamycin 300 Mg Injection40
VulvoclinVulvoclin 100 Mg/100 Mg Capsule56
CefrobactumCefrobactum 500 Mg/500 Mg Injection100
ClinClin 3 Gm Tablet62
Cefstar ForteCefstar Forte 1000 Mg/500 Mg Injection239
CeftocinCeftocin 1000 Mg/1000 Mg Injection188
Ceftop (Intel)Ceftop 1000 Mg/500 Mg Injection85
CefuboldCefubold 1000 Mg/500 Mg Injection304
CefumCefum 500 Mg/500 Mg Injection0

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References

  1. Kleopatra Alexiadou, John Doupis. Management of Diabetic Foot Ulcers. Diabetes Ther. 2012 Dec; 3(1): 4. PMID: 22529027
  2. David G. Armstrong. Diabetic Foot Ulcers: Prevention, Diagnosis and Classification. Am Fam Physician. 1998 Mar 15;57(6):1325-1332. American Academy of Family Physicians; [Internet]
  3. American Podiatric Medical Association. What is a Diabetic Foot Ulcer?. Advancing Foot and Ankle Medicine and Surgery; [Internet]
  4. Sue E. Gardner et al. Clinical Signs of Infection in Diabetic Foot Ulcers with High Microbial Load. Biol Res Nurs. Author manuscript; available in PMC 2010 Oct 1. PMID: 19147524
  5. Feingold KR, Anawalt B, Boyce A, et al. The Diabetic Foot. Endotext [Internet]. South Dartmouth (MA): Inc.; 2000-.
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