What to know about diabetic foot ulcers
Foot ulcers are more likely in people who have had diabetes for many years, especially once feeling in the feet has faded. Anyone who has had an ulcer or an amputation before is at higher risk, because healed skin stays fragile and the pressure pattern behind the first wound is often still there. Other things that raise risk include poor circulation in the legs, kidney disease, changes in foot shape such as hammertoes, bunions or a collapsed arch, vision loss that makes foot checks hard, and trouble bending to reach the feet. People who live alone, or who cannot easily get properly fitted shoes, are more exposed too. None of this makes an ulcer certain. It tells clinicians whose feet to watch closely.
How the care plan is built
Part of building a plan is finding out what a person can realistically do. Expect the treating clinician to ask questions such as:
- How far do you walk in a day, and on what surfaces?
- Can you see and reach the bottoms of your feet?
- Who is available to help with dressings?
- Have you had an ulcer, foot surgery or an amputation before?
- What has already been tried on this wound?
The answers shape the choice of offloading device and the dressing schedule. A plan that fits daily life is one a person can keep following, and reassessment at each visit shows whether it is working.
Arranging this care in Madison County
People in Madison County with a diabetic foot ulcer often split their care between two states: a primary care office and hospital in Illinois, and a vascular surgeon or foot specialist in St. Louis. Records do not always follow across the river. Gateway requests them from both sides so the treating clinician can see the circulation studies, cultures and imaging already done. If a specialist visit in Missouri is ordered, we first check whether your plan and that provider work together, then help with transportation across the bridge so the foot is not walked on more than necessary.
Madison County reaches from the Mississippi River at Alton and Granite City, over the bluffs to Edwardsville, Glen Carbon, Maryville and Collinsville, and east through farmland to Troy and Highland. Godfrey, Wood River and Bethalto fill in the north. That is a lot of ground, and the distance to a wound clinic or a doctor’s office varies widely from one town to the next. People who cannot travel easily, whether they live in a river-town bungalow or on a rural road, gain the most when care is arranged where they live.
At home between visits
When dressings need changing more often than visits occur, the treating clinician may order home health nursing, and Gateway helps set that up with an agency that serves your area. The agency nurse follows the wound orders and reports changes back. Supplies are the other piece. Dressings, wraps and offloading devices are ordered by the clinician, and we track each order so the right sizes arrive before the current stock runs out. Store supplies together in one clean, dry place, and tell us early if a box is running low or if the boot or shoe no longer fits well.
For residents of nursing and senior living communities
In a skilled nursing facility, a diabetic foot ulcer is managed by several people at once. A partner clinician visits on site to assess the wound and write or recommend orders, the facility nurses carry out dressing changes and daily skin checks, and the attending physician oversees the resident’s overall care. Gateway keeps those lines connected. We schedule rounds with the facility, send visit notes for the chart and confirm that new orders were received and signed as the building requires. Offloading orders, such as heel protection in bed or a boot for transfers, go to the nursing and therapy staff who apply them every shift.
What to report and when to call 911
Some changes point to trouble with blood flow or to tissue that is dying. Report these to the treating clinician without waiting for the next visit:
- Black, gray or dark purple skin on a toe, the heel or the wound edge
- A wound that looks deeper, or one where bone or tendon can be seen
- A toe that has become cold or discolored
- Foot pain at rest or at night that eases when the leg hangs down
Call 911 if a foot or leg suddenly turns cold, pale or blue, or for chest pain, severe bleeding or loss of consciousness.
Primary care and overall health
Healing an ulcer takes protein, calories and fluids, and that can pull against an eating plan built around blood sugar or kidney disease. Sorting out what to eat while a wound is open is a question for the primary care clinician or a dietitian. Medications deserve the same review. Some can affect swelling, blood sugar or healing, and only the prescribing clinician should adjust them. Arranging wound care and primary care together means these questions are asked by someone with the full medication list and recent lab results in hand, not saved for an appointment that is months away.
Arranging diabetic foot ulcer care in Madison County
For a resident of a nursing home, assisted living or memory care community in Madison County, a request for diabetic foot ulcer care can come from the family, the resident or the facility’s nurses. Call 314-325-0126 and give us the facility name, the unit or room and the best nurse contact. Gateway speaks with the facility about its process for outside clinicians, confirms availability and coordinates a visit time that fits the resident’s day. After the visit, the treating clinician’s orders are given to facility nursing, and the family contact on file gets an update if the resident has agreed to that.
Madison County patients are discharged from several hospitals: Anderson Hospital in Maryville, Alton Memorial Hospital, OSF Saint Anthony’s Health Center in Alton, Gateway Regional Medical Center in Granite City and HSHS St. Joseph’s Hospital in Highland. Gateway Wound Care is not affiliated with any of them, and follow-up can be requested no matter where the stay took place. A family member or discharge planner tells us where the patient is headed, whether home or a facility. We then obtain the discharge orders and arrange a visit with a partner clinician once availability for that location is confirmed.
- County: Madison County, Illinois
- ZIP codes: 62025, 62034, 62234, 62040, 62002, 62035
- Nearby hospitals: Anderson Hospital in Maryville; Alton Memorial Hospital; OSF Saint Anthony's Health Center in Alton; Gateway Regional Medical Center in Granite City; HSHS St. Joseph's Hospital in Highland (not affiliated with Gateway)
- Nearby communities: Edwardsville, Glen Carbon, Collinsville, Granite City, Alton, Godfrey, Illinois
- Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation
Related care in Madison County
Read the full guide to diabetic foot ulcers, or see everything Gateway arranges on the mobile wound care in Madison County page.
- Venous leg ulcers
- Pressure injuries and bed sores
- Arterial and mixed wounds
- Non-healing wounds
- Post-surgical wounds
- Reopened (dehisced) surgical wounds
- Surgical site infections
- Skin tears and traumatic wounds
- Wounds with lymphedema
- Skin graft aftercare
- Wound VAC (NPWT) follow-up
- Diabetic foot ulcer care in Edwardsville
- Diabetic foot ulcer care in Glen Carbon
- Diabetic foot ulcer care in Collinsville
- Diabetic foot ulcer care in Granite City
Common questions
How do I start diabetic foot ulcer care in Madison County?
Call 314-325-0126 or send the request form with your name and phone number. Please leave medical details out of the form. We will call back to ask where you live, who is involved in your care and what has been tried so far. Then we confirm which partner clinician can see you and set up the first visit.
Does a diabetic foot ulcer always mean there is an infection?
No. Every open wound has bacteria on its surface, and that is different from infection in the tissue. When clinicians suspect infection, they may order a culture, blood work or imaging to find out how deep it goes. Antibiotics are prescribed only when the clinician judges they are needed. Report changes quickly all the same, because infection in a diabetic foot can spread fast.
What should I have ready for the first visit?
Gather a current medication list, recent blood sugar readings if you keep them, and any hospital or clinic papers about the foot. Set out the shoes, inserts, boot or other devices you use, along with the dressing supplies you have on hand. Write down the names of your doctors and your questions. A chair with good light and a place to prop the foot make the exam easier.
Which Madison County towns does Gateway cover?
Gateway arranges care in Edwardsville, Glen Carbon, Collinsville, Granite City, Alton and Godfrey, and takes requests from other Madison County communities such as Maryville, Troy, Highland, Wood River and Bethalto. Availability is not identical everywhere. It is confirmed by location and care setting, so the simplest step is to call 314-325-0126 with the address and ask.
General information to help you talk with your own clinician. It is not medical advice, and the treating clinician makes every clinical decision. For a medical emergency, call 911.