Diabetic foot treatment in Amman starts with a careful assessment of the wound, the nerves and the blood flow to the foot. Treatment is then chosen to suit the case: wound care and taking pressure off the wound, treating infection, and improving blood flow when needed, to help the wound heal and protect the foot.
Note: Do not delay treatment of any foot wound if you have diabetes. If redness or swelling spreads quickly, or you have a fever, a bad-smelling wound, or the foot turns blue or black, go to the emergency department straight away.
Symptoms
People with diabetes may not feel pain in their feet, so watch for these signs:
- A sore or ulcer on the foot that does not heal or gets worse.
- Numbness, tingling, burning or loss of feeling in the feet.
- A cold, pale foot, or skin turning blue or dark.
- Redness, swelling or warmth around a wound or in the foot.
- Discharge or a bad smell from a wound.
- Leg pain when walking that eases with rest, which can be a sign of leg artery blockage.
- Cracked skin, corns or calluses, or a change in the shape of the foot.
Causes
Diabetic foot problems usually come from several factors together:
- Diabetic nerve damage (neuropathy), so small injuries go unnoticed.
- Poor blood flow from narrowed arteries, which slows wound healing.
- Blood sugar that stays high for a long time, which weakens the body's defence against infection.
- Repeated pressure on parts of the foot from unsuitable shoes or foot deformities.
- Smoking, which damages the arteries and slows healing.
- Minor injuries such as burns or cutting nails too short, which may not be felt.
Diagnosis
An accurate diagnosis is the base of the plan. The doctor examines the foot and the wound carefully and asks about your diabetes, medicines, smoking and other health conditions.
Because blood flow has a big effect on healing, most patients have a foot circulation assessment.
- Checking the feeling in your feet.
- Feeling the pulses in the foot and leg.
- Your doctor may request a Doppler ultrasound or other artery tests.
- An X-ray of the foot if infection may have reached the bone.
- Blood tests to check blood sugar and signs of infection.
- A swab or sample from the wound if it looks infected, to guide treatment.
Treatment options
Options are listed from the simplest to the most invasive. Many patients need more than one at the same time:
The choice of treatment depends on the examination, the state of the wound and arteries, and your general health. Your doctor will explain the suggested plan and the reasons for it.
- Controlling blood sugar, stopping smoking and following daily foot care. These support every other treatment.
- Regular wound care: cleaning the wound and changing dressings as your care team advises.
- Taking pressure off the wound (offloading) with special shoes, a cast or padding so it can heal.
- Treating infection with medicines your doctor prescribes based on the type and severity, as explained on the diabetic foot infection treatment page.
- Surgical cleaning of the wound (debridement) to remove dead tissue and help healing.
- Improving blood flow to the foot when arteries are blocked, often through peripheral artery angioplasty, or with bypass surgery in some cases.
- Surgery to drain an abscess or remove tissue that cannot be saved, to protect the rest of the foot.
What to expect on the day and after
Your visit starts with a talk about your health history and an examination of both feet. You may be asked to have some tests, and then the suggested treatment and how to care for the wound at home will be explained.
- Regular follow-up visits to check the wound and adjust treatment.
- Keeping pressure off the foot and changing dressings as shown.
- Keeping track of your blood sugar with your regular doctor.
- Healing time varies from person to person, and your surgeon will explain what to expect in your case.
- After healing, suitable footwear and regular foot checks remain important, because ulcers can come back.
When to book an appointment
Book an assessment if you notice:
- A foot wound that is not improving despite care.
- A change in the colour or temperature of your foot.
- Leg pain when walking, or foot pain at rest.
- Numbness or loss of feeling in your feet.
- Corns, cracks or deformities that are bothering you.
- A doctor has mentioned amputation and you would like the circulation and wound assessed.