Diabetic foot ulcers result from a dangerous combination of factors that diabetes creates:

Peripheral Neuropathy (Nerve Damage) High blood sugar levels over time damage nerves in the feet, causing loss of protective sensation. Patients cannot feel pressure, heat, or pain that would normally warn of injury. A small blister, cut, or area of pressure can progress to a serious ulcer without the patient realizing anything is wrong.

Poor Circulation (Peripheral Arterial Disease) Diabetes damages blood vessels, reducing blood flow to the feet and lower legs. Inadequate circulation means wounds receive less oxygen and fewer nutrients needed for healing. Even minor injuries struggle to heal and become chronic wounds.

Impaired Immune Function Elevated blood sugar impairs the immune system's ability to fight infection. Once bacteria enter a diabetic foot ulcer, the body cannot mount an effective defense, allowing infections to spread rapidly.

Foot Deformities and Abnormal Pressure Diabetes can cause changes in foot structure—hammertoes, bunions, Charcot foot—that create abnormal pressure points. These high-pressure areas are where ulcers most commonly form.

Common Ulcer Locations:

• Ball of the foot (under metatarsal heads)

• Tips of toes

• Bottom of the big toe

• Between toes (from friction)

• Heel