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January 24, 2002


Question from East London, South Africa:

Six months ago, my granny was bitten by a scorpion and just after we thought it had cleared, she developed an ulcer. Although the doctor has given various medications, it does not seem to get better. What is a diabetic ulcer? How do you treat it? Can my granny lose her leg from it?


Over time, diabetes can damage the blood flow to the legs. Likewise, diabetes can damage the nerves to the legs. Injuries are not felt and healing is delayed because of the poor circulation. A diabetic skin ulcer is really not different from the lesions anyone with impaired circulation could get. It is a wound that does not heal and leads to a long term breakdown of tissue, called an ulcer.

It requires specialized attention with good care, antibiotics frequently and sometimes resting of the extremity. Your granny needs to see someone competent in treating these problems since she could face an amputation of the extremity if not attended to properly.


[Editor’s comment: An important aspect of healing the ulcers is to have diabetes in meticulous control which means blood sugars in the normal range most of the time with a hemoglobin A1c less than 1% above the upper limit for the lab performing the test. This might require treatment with insulin. Also, see Diabetes and Foot Pain at the Diabetes Monitor, for more information.