A Diabetic Foot Ulcer
By Maria T. Martinez, community health educator
February 20, 2010

Carlos is 62-year old, insulin dependent with a 20-year history of diabetes.  After a two week stay in a local hospital, he was sent home after suffering from neuropathy and severe pain. Carlos lived alone with no family nearby, limited support and only able to count on friendships and the church ministry for assistance. He needed to follow-up on his doctor appointments and a new prescription medicine regime.

The Care Team at his church volunteered to make weekly home visits to help with medications, housekeeping, and to provide emotional support.  After a couple of weeks of home care, Carlos noticed a crack on the bottom of his foot, a result of the winter cold and the low humidity. In days, tissue around the lesion became inflamed and necrotic. He had developed a foot ulcer.

Over time, diabetes can damage the blood vessels and nerves, especially if a person’s blood sugar is poorly controlled. Poor circulation and nerve damage in the feet makes people vulnerable to sustaining cuts or other injuries that go unnoticed and progress into poorly healing ulcers, or sores. Severe cases can ultimately lead to amputation (Diabetes Care, December 2009).

The primary goal in the treatment of diabetic foot ulcers is to obtain wound closure. Management of the foot ulcer is largely determined by its severity, and the presence of infection. Rest, elevation of the affected foot, and relief of pressure are essential components of treatment and should be initiated at first presentation (Journal of the American Academy of Family Physicians, November, 2002). 

In Carlos’ situation, one of the visiting nurses in the Care Team provided education on foot hygiene, proper footwear and referral for treatment of lesion (This is an example of the kind of continuing care provided by congregation-based care team ministries sponsored by Congregational Health – a ministry outreach of Baptist Health South Florida). 

Prevention of a new or subsequent foot ulcer is key to avoiding amputation.

For related health education resources and information on our upcoming Post-Hospitalization Spiritual and Practical Care (PHSC) courses, please contact Maria T. Martinez, community health educator at 786-594-6751.