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Why do wounds appear on the legs of a diabetic patient?

Q: My father is a sugar patient. He doesn't do much physical work for the past two years. I could see some wounds appearing on legs here and there - mainly beneath the knees and below the knees and at the top of the foot. I stress appearing, because they appear without any physical cuts. The nature of the wounds - generally, if there is a cut on the skin, after some days when the wound gets cured, that part will get black skin. In my case, the wound while appearing itself looks like a black skin. The wound gets cured without any medicine. But, it leaves out a black mark in that place. And some wounds appear just like a black mark (that part of the skin looks like burnt). Will it be a normal one due to heat? or due to friction (beneath the knees and the friction with the floor)? or something else due to sugar problem? He is taking treatment for diabetes for past 8 years.

A:Without an examination, it is difficult to say what the problem is, but I can make a guess, that your father has quite significant peripheral neuropathy and peripheral vascular disease. In simple words, that he has damage to: a) the nerves of his legs, causing decreased sensation, so he cannot make out when he gets minor injuries without the warning that pain gives all of us, b) the blood supply of his legs, so the wounds are healing in this manner. You have not mentioned what his glycosylated haemoglobin levels are, i.e. how well his diabetes is controlled, why he is not exercising regularly, whether he is taking low dose aspirin or not, whether he has high BP or not, and if so whether it is controlled or not. All these issues will have to be taken into account in managing the problem, which should not be lightly dismissed even though the wounds are healing on their own at present. Please get in touch with a good physician/ diabetologist for proper treatment.

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