The Center for Podiatric Care and Sports Medicine

Why Some Diabetic Foot Wounds Won’t Heal? Exploring Reasons from Circulation to Neuropathy

Posted by on Monday, November 11th, 2013


Our NYC foot doctors see many patients with systemic diseases like diabetes. Podiatrists are often troubled by these cases.  Despite our best advice, it seems the foot issues diabetic patients report continue to persist for many months and fail to heal as we hope they would.

At The Center for Podiatric Care and Sports Medicine, our goal is to make you feel as comfortable as possible and present the most logical approaches for the treatment of your diabetic foot wounds. In this article, a few of our diabetic foot experts discuss a few reasons why the current therapies may not be working.

slow wound healing diabetics
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Why Are Diabetic Foot Wounds So Hard To Treat?

There are many factors affecting the healing of foot wounds that are unique to diabetics. Here are a few:

Lack  of compliance

“The most common reasons diabetic foot wounds do not heal are probably lack of sugar control and lack of patient compliance with keeping pressure off the wound,” says Dr. Nadia Levy. While patients tend to be very educated about the importance of wearing the right shoes, putting their feet up for intervals throughout the day, and adhering to a closely monitored diet, the reality is that most patients struggle with these lifestyle changes. Many patients misunderstand advice such as “You shouldn’t walk on an ulcerated limb,” stating, “Well, you didn’t say I couldn’t walk on it at all.” Unfortunately, some patients feel ambivalent and helpless about a chronic condition like diabetes, stating, “There is nothing I can do; I’ve been having this problem for years.”

Poor circulation

“Some diabetic patients have poor circulation that requires treatment from a vascular doctor to improve the blood flow to their feet in order for the wounds to heal,” says NYC podiatrist Dr. Katherine Lai. Wounds generally heal when four phases occur: hemostasis, inflammation, proliferation, and remodeling. Oxygenation from adequate blood flow plays an especially important role in all of these phases.

stages of wound healing
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“Diabetics can suffer from peripheral neuropathy, where there is a lack of normal protective sensation in the feet,”  Dr. Ryan Minara says. “This is a dangerous combination because a diabetic can suffer an open wound to the foot that they may not even feel.  If their circulation is compromised, this wound may not heal properly and this can lead to severe infections of the soft tissue and bone.”

neuropathy infographic
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What Can A NYC Podiatrist Do To Help?

We can point you to creams and medications that can expedite healing. We can also show you different types of footwear that will take the pressure off your wound to allow for improved circulation and tissue repair. You’ll find that most treatments are painless and relatively conservative. Very rarely do we find the need for more invasive debridements or foot surgeries to help our diabetic patients. Should you require the care of a surgeon, we do cover all types of treatment at our two New York offices.


If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.