Diabetic Foot Ulcers Can Lead to Cognitive Decline

In Conditions by Alnoor Ladhani, Chiropodist

Diabetic foot ulcers are open wounds or sores that develop mainly on the bottom of the feet for some diabetic patients. Ulcers may be caused by a variety of factors, including poor circulation and neuropathy (a condition where the patient has reduced or complete loss of feeling in the foot, including the ability to feel pain — this is caused by nerve damage as the result of high blood sugar levels over a long period of time).

In a study conducted by researchers at Ben-Gurion University in Israel, it was shown that patients with complications like foot ulcers from diabetes were also at a higher risk for cognitive issues down the line. This finding ties into the general consensus that diabetes is a complex disease that ultimately affects the entire body on many different levels – not just the function of the pancreas.

Diabetic foot ulcers

Details of the Study

During the study, 99 patients with diabetes were cognitively tested before and after they developed foot ulcers. All patients reported similar cognitive functioning to begin with. Among the patients who developed ulcers, the cognitive decline was drastic in comparison with those patients who did not develop ulcers. The patients who developed foot ulcers ultimately showed reduced concentration and slower motor responses, learning and memory problems, decreased verbal fluency, and reduced inhibition.

According to researchers, diabetes has been previously linked with decreased cognitive function. However, foot ulcers, which involve vascular changes on both micro and macro levels, can speed this up. This is because vascular changes can negatively affect organs such as the brain.

How to Prevent Diabetic Foot Ulcers and Cognitive Decline

An article from the American Podiatric Medical Association (APMA) details the causes, treatments, and prevention measures for diabetic wound care like ulcers. You can prevent diabetic foot ulcers and connected cognitive decline with careful attention to health and diabetes management.  Besides having diabetes, the risk factors for developing foot ulcers are the following:

  • Poor circulation
  • Neuropathy
  • Blood glucose (also called blood sugar) that is uncontrolled
  • Foot deformity (bunions, hammer toe, etc.)
  • Wearing inappropriate shoes

Here are some key prevention methods if you are at a higher risk for developing ulcers.

  • If you have diabetes, it’s essential that you keep your blood sugar levels as regulated as possible, which is done mainly through proper diet, regular exercise, and insulin.
  • If you are at risk, see a chiropodist regularly to have your feet checked for any signs of developing ulcers.
  • Wear proper shoes that are comfortable and do not chafe or cause friction against the skin.
  • Learn how to check your feet yourself for signs of problems, and seek immediate medical advice if you notice anything suspicious.

Treatment for Diabetic Foot Ulcers

Foot ulcers are treated with the goals of preventing infection and speeding up the healing process. Foot ulcers especially must be treated professionally to prevent infection that may progress quickly and require amputation of the foot. Treatment has a few different variables. They are:

  • Keeping the foot ulcer clean as well as bandaged with some kind of dressing. Keeping the wound covered speeds healing.
  • Avoiding putting pressure on the open wound. This is called “off-loading” and may require special footwear or crutches.
  • Removing excess dead skin (“debridement”).
  • Medication applied directly to the affected skin.
  • Keeping blood glucose under control.

Depending on wound care, circulation, how well blood glucose is kept in check, and other factors, a foot ulcer can take anywhere from a few weeks to a few months to fully heal. If the above treatments end up not working, however, surgery is an option.

The Bottom Line

Patients should be aware that by preventing diabetic foot ulcers and/or treating them effectively and quickly, they can possibly avoid the negative cognitive effects as outlined in the study from Ben-Gurion University. Diabetics need to understand how the disease affects the whole body and how to manage it, not just with pills or injections, but also with diet, exercise, and careful health monitoring.

Regular visits to the chiropodist in particular can help minimize problems with the feet. At Step By Step Professional Family Foot Care, we have the expertise for all of your diabetic foot care needs. Contact us today to set up your appointment.