Most diabetic foot ulcers are like "icebergs." Unlike a normal wound, such as a scrape or cut, a diabetic foot ulcer can be largely hidden. It may appear small on the surface but extend very deep, even to the bone. More often, diabetic foot ulcers begin with pressure on the bottom of the foot. Added pressure on the skin close to the bones in the foot causes bruising and tissue damage. But much of it is hard to see. People with diabetes commonly have risk factors that can contribute to diabetic foot ulcers, such as poor blood flow, nerve damage in their feet, and changes in the bone and muscles of the foot. A diabetic foot ulcer can be caused by a minor event such as wearing tight shoes that cause a blister or a more serious event such as stepping on a sharp object, or suffering a burn from bath water or pavement that is too hot. Poor blood flow Poor blood flow means that there is not enough blood rich in oxygen and growth factors flowing to your foot. Nerve damage Nerve damage, which your doctor may call "neuropathy," is when the nerves in your feet no longer function properly. This will cause a loss of feeling in your feet. Change in muscle and bone Changes in muscle and bone can lead to areas of high pressure and injuries Neuropathy, poor blood flow, and changes in muscle and bone can lead to a diabetic foot ulcer, but there are some important things your doctor can do to heal this potentially serious injury.

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