Diabetic ulcers are the primary cause of amputations of the foot and lower leg. The ulcers are usually located on the bottom of the foot and begin as a callus, which the patient may not feel because of diabetic nerve damage (neuropathy). When the callus thickens into the surrounding tissue it forms a deep bruise, which causes tissues to break down. Eventually an ulcer appears and can become infected. Small, unnoticed cuts and punctures can also lead to diabetic ulcers.
Reduced pain sensation caused by neuropathy and poor circulation in the extremities (a common diabetic complication) keeps the ulcer from healing. If untreated, the ulcer can lead to life- and limb-threatening infection. Fortunately, there are effective treatments for these serious wounds.