Curiosin - Even chronic wound healing can be fast

Diabetes related foot complications can be prevented
There are nearly 700 000 diagnosed diabetic patients in Hungary and there are even more of those who are unaware of their illness. Over 10% of the population is exposed to diabetes related complications, the most serious of which are wounds appearing on the foot area since they are hard-to-heal, often become infected and may lead to loss of limb.

Dr. László Mecseky
Diabetic Leg Specialist
President of Diabetic Leg Alliance, Hungary
Founder of National Diabetic Leg Screening Program at Hungary





Diabetes is often accompanied by the damage of sensory nerve fibres signalling heat and pain on the limbs, i.e. the so-called neuropathy.  As a consequence of this, the foot deforms and signs of overexertion appear on the sole, which are indicated by corns and callosities. The skin becomes dry and vulnerable, dangerous nail lesions entailing fungal infections often appear.

Another consequence of neuropathy is insensitivity, the complete loss of pain sensation which normally activates the defensive mechanisms of the body, which is why the patient does not notice minor injuries nor feel hits. It is these unnoticed injuries that lead to the appearance of ulcers.

In addition to the nerve damage, the behaviour of the capillaries changes and the structure of the skin alters as well.

The hyaluronate content of the skin, which is high at birth, decreases in time. In old age this is the reason why wrinkles appear.

The hyaluronate-level of diabetic patients decreases to nearly zero regardless of their age!

However, the appearance of foot wounds can be prevented if, in addition to the patient’s medical treatment and adherence to a proper diet, proper inspection of the foot as well as foot and skin treatments are carried out according to the physician’s instructions in surgeries, diabetes nursing facilities or diabetes foot outpatient care centres in due time.

With the regular use of gels containing zinc-hyaluronate the skin can be made more resistant. Corns and callosities on the overexerted points of the sole can be softened, which makes their removal easier. This way the risk of the appearance of ulcer on critical points of exertion can be minimized.


During walking bruises in the soft issues under the callosities may appear invisibly and unnoticed. These can become infected if foot hygiene is inadequate and this is where the real problems begin.

In many cases it is easier for the inflammation to spread into the deep tissues than towards the surface through the callosities, which is problematic as in most cases deep inflammation of the tissue remains unnoticed until the calf becomes affected and swells. At this point it is very difficult to reverse the process and in most cases there is no other option than to amputate the limb.

It is not an overstatement that the regular removal of callosities by a professional can save one’s limbs or even life.

Protective shoes and insoles (ortheses) designed to relieve the pressure on the foot have an important role in preventing foot complications. Their use is recommended even when there is no visible sign of wounds on the feet as yet.

Proper diabetes protective shoes have hard soles and they are deep in order to provide enough space for the tailor-made pressure relief distribution insole, i.e. orthesis to fit close to the sole in the entire surface. The hard sole is important because complications characteristically appear in the line of the joints between the toes and the metatarsal bones and this way exertion and shear force can be minimized.

However, the availability of such tailor-made protective shoes is not perfect at present. One has to pay special attention to look for facilities where these demands are catered for.

Unfortunately many diabetic patients are not aware of the dangers of diabetes and therefore do not attend regular medical care or treatment.

With examinations carried out in due time, neuropathy and its adverse consequences can be discovered, the chance of complications forecast. However, it is the patients’ responsibility to pay due attention to their own illness and do their best to prevent any unwanted event.

The feet always warn us about upcoming problems with easily perceptible signals.

It is important for diabetic patients to

continuously treat the underlying disease, attend to the foot skin properly and use protective shoes, orthesis.

By observing these rules the appearance of foot wounds could be prevented.

The reason for that is that these foot lesions typically do not hurt, which is why they are usually neglected. This is a pity since when the wounds have already appeared on the foot, it is a lot more difficult and considerably more expensive to achieve any progress and prospects for recovery are much grimmer as well.


Dr PhD László Mecseky
Diabetes Foot Outpatient Care Centre, Medi-Dhoro Ltd.
Budapest, Miskolc, Debrecen, Balassagyarmat