The swelling can affect the motor nerve supply of small intrinsic muscles of the foot causing decreased sensory perception of pain. The sympathetic nerve supply may also be damaged which results in lack of sweating. In combination, the result is dry cracked skin, which can become infected. However, in accumulation these injuries can lead to lesions and larger wounds on the feet and toes. Angiopathy and Ischemia Diabetics have a higher incidence of atherosclerosis than non-diabetics do.
Ischemia can then lead to an increased chance of infections.
Although humoral immunity appears to go unaffected by diabetes there is however a depression in the cellular immunity. Consequently, diabetics have problems with phagocytosis and intracellular microbicidal function. This may be due to angiopathy and low tissue oxygen levels. Treatment of Diabetic Foot Ulcers Traditional treatment for diabetic foot ulcers can include many steps such as local wound care, debridement, immobilization of the foot, control the underlying diabetic hyperglycemia, drainage, and sometimes amputation. Choice of antibiotic in moderate to severe infection relies on the findings from cultures taken from the site of infection.