Patient/caregiver were instructed on the signs and symptoms of diabetic foot ulcers as follows:
- Certain pressure points on the bottom of the feet, such as, skin on the ball of foot and heel, are increasingly exposed to mechanical factors, such as, friction, pressure, and shearing stress.
- These pressure points on the feet, in response to continuous exposure to mechanical factors, develop calluses, which are hardened portions of the skin.
- Diabetic foot ulcers usually develop within these calluses on the ball of foot and heel. However, coexisting factors like arthritis, obesity, and poorly fitting footwear contributing to altered gait patterns can involve other areas of the foot too, depending on the site of foot increasingly exposed to the mechanical factors.
- Diabetic foot ulcer usually is a full-thickness skin loss, with a circular punched out appearance surrounded by hard callus. Due to the neuropathy in poorly managed diabetics, individuals often have poor sensation at the ulcer site, which contributes to the painless nature of the wound. As these wounds are mostly painless, it is often delayed by the time these wounds are realized. Patients, secondary to neuropathy, can as well present with burning, altered/tingling sensation, or numbness of the feet.
- As individuals could be walking and moving around without realizing the wounds on the feet, these wound sites are increasingly exposed to risk for further friction & pressure and risk for infections. This can lead to worsening of the wounds due to complications, such as, infection and dead tissue formation, before the wounds are even realized.
