What to do if diabetic foot ulcer occurs?

Written by Zhao Xin Lan
Endocrinology
Updated on May 13, 2025
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If diabetic foot ulceration occurs, the most important first step is surgical debridement to remove necrotic tissue and thoroughly clean the wound. If the ulceration is particularly severe and there is gangrene, and the foot can no longer be preserved, amputation may even be necessary. Secondly, anti-infection treatment should be administered, choosing sensitive antibiotics. The third step is to control the underlying condition; treatment must control blood sugar levels to avoid hyperglycemia, as high blood sugar serves as a culture medium for bacteria. Fourth, it is necessary to improve local blood circulation; diabetic foot often coexists with arteriosclerosis of the lower limb arteries, even leading to occlusion. Therefore, it is necessary to improve the circulation of local blood vessels and open up the vessels. Fifth, the nutritional treatment of peripheral nerves must be improved. Treatment of diabetic foot is a comprehensive approach.

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Written by Li Hui Zhi
Endocrinology
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Is it good for people with diabetes to soak their feet?

Whether soaking the feet is beneficial for diabetic foot or not first depends on whether there are any wounds on the feet. If it is a grade 0 diabetic foot, where the diabetic only experiences abnormal sensations, numbness, or pain in the foot without any wound, then soaking the feet is permissible. However, it is crucial to be mindful of the water temperature during soaking; it generally should not exceed 40°C to avoid burns. If the diabetic foot has open wounds, foot soaking is not recommended. Soaking feet with wounds can easily lead to increased infection of the wounds.

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Written by Li Hui Zhi
Endocrinology
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What are the symptoms of diabetic foot infection?

Symptoms of diabetic foot infections can include localized gradual wound ulceration, suppuration, and odor. In severe cases, patients may observe necrosis of the foot with a dark color. Some patients may experience systemic effects, including fever. Therefore, the progression of diabetic foot can be rapid. It is recommended that diabetic patients seek medical attention promptly when they notice any wound ulceration to prevent worsening of the infection.

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Written by Yang Li
Endocrinology
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How to relieve pain in diabetic foot?

If diabetic foot is combined with pain, it often depends on the severity of the diabetic foot. It has a Wagner grading system. If there is an obvious wound that extends to the bone, anti-infection treatment is very important, and surgical assessment is necessary to determine if the foot can be saved. If the wound is superficial and only involves the epidermis, local anti-infection and circulation improvement are fundamental. In such cases, COX-2 inhibitors and non-steroidal analgesic drugs may be used. If the pain is caused by peripheral neuropathy, the first step is to nourish the nerves, for example with mecobalamin, and treat the neuropathy with drugs like epalrestat, along with drugs like cilostazol that improve microcirculation. Effective treatments targeted at this type of neuropathic pain include drugs like pregabalin and etoricoxib, designed for bone pain, and gabapentin-related medications can also be used. (Medication should be used under the guidance of a doctor.)

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Written by Zhao Xin Lan
Endocrinology
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How to treat diabetic foot early

First of all, in the early stages of diabetes, it is necessary to control blood sugar to prevent the occurrence of diabetic foot. If diabetic foot has already appeared in the early stages of diabetes, then it is important to prevent the further development of diabetic foot into late-stage ulceration and gangrene. Firstly, proper care should be taken to avoid damage to the skin. Secondly, it is crucial to control blood sugar, complete examination of lower limb vascular ultrasonography or angiography, ascertain the extent of lower limb vascular lesions, and improve blood circulation. If there is an occlusion of the blood vessels in the lower limbs, surgical methods should be used as soon as possible to open the vessels and maintain blood supply, to prevent further deterioration.

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Written by Li Hui Zhi
Endocrinology
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Is it good for people with diabetes to soak their feet?

Diabetic foot is primarily classified into a level 0 diabetic foot and levels 1 to 5 diabetic foot. If it is a level 0 diabetic foot and the patient does not have any wounds, then soaking the feet is permissible. Level 0 diabetic foot mainly refers to a high-risk diabetic foot, in which case soaking is allowed. However, care must be taken to ensure that the water temperature is not too high to avoid scalding the skin. If the diabetic foot has reached levels 1 to 5, where the patient has wounds and ulcerations, soaking the feet is not recommended, as it can easily worsen and exacerbate the wound ulcerations. Therefore, people with diabetes should consider their individual conditions to determine whether foot soaking is suitable.