What to know about diabetic foot ulcers

Change in a diabetic foot ulcer comes slowly, which is why the wound is measured at regular visits. In the early weeks of care, clinicians look for the wound to become smaller and shallower and for healthy red tissue to fill in the base. A wound that stays the same size visit after visit is a signal to look for a cause instead of simply waiting longer. Setbacks are common. A few days in the wrong shoes, or a stretch without the protective device, can undo progress. Once the skin closes, the area stays weaker than the skin around it, and ulcers often return at or near the same spot. The months after closure call for protective footwear and continued foot checks.

What the treating clinician looks at

At the first visit the treating clinician usually measures the length, width and depth of the ulcer and notes what the base looks like: pink or red tissue, yellow slough, dark dead tissue, or structures that should not be visible. The edges get attention too, because a thick rim of callus or skin that has been undermined changes the plan. The amount, color and odor of any drainage are recorded. The clinician may also check whether the wound reaches toward bone, since that raises the question of bone infection and may lead to imaging or lab work. These findings become the baseline that later visits are measured against.

Diabetic foot ulcer care in Glen Carbon

On the Illinois side of the river, foot ulcer care starts with questions about paperwork. A person in Glen Carbon may have Illinois Medicaid, a Medicare Advantage plan built around Illinois hospitals, or an employer plan based in Missouri, and each can treat wound visits, offloading devices and dressings differently. Gateway confirms which partner clinician can see you and asks about benefits before scheduling, so an ordered boot or supply shipment is less likely to be held up later. Coverage depends on the treating provider, your plan and the care needed, and we will tell you what we learn.

Glen Carbon is a village on the south side of Edwardsville, close to Interstate 270, with Illinois Route 157 along its older west end and Route 159 through its commercial center. It started as a coal mining village and has grown into a largely residential community of subdivisions. People tend to settle here and stay. As a result, many residents are managing wounds, diabetes, heart conditions or recovery from surgery in homes they have owned for years, and they need care that can come to them.

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.

Signs to tell the clinician about

Infection is the change clinicians most want to hear about early, and in a numb foot it may not hurt. Contact the treating clinician promptly if you notice:

  • Redness that is spreading, or a red streak moving up the foot or leg
  • Skin around the ulcer that feels warmer than the other foot
  • Thicker, cloudy or foul-smelling drainage
  • New swelling of the foot or ankle
  • Fever, chills or feeling generally unwell

Call 911 for confusion, a racing heart, trouble breathing or fainting. Gateway is not an emergency service.

How primary care fits in

The blood that reaches the foot is what feeds a healing ulcer, and the health of the arteries is largely a primary care matter. Blood pressure, cholesterol, kidney function and tobacco use all affect the vessels in the legs. A primary care clinician tracks these, orders the lab work and can coordinate referrals to vascular or kidney specialists when the wound clinician raises a concern. Leg swelling from heart or kidney conditions matters as well, because a swollen foot fits poorly in an offloading device. When Gateway arranges both kinds of care, findings from one visit can inform the other instead of sitting in separate charts.

Primary care at home in Glen Carbon →

Arranging diabetic foot ulcer care in Glen Carbon

Setting up diabetic foot ulcer care for someone in Glen Carbon usually goes in this order:

  1. You call 314-325-0126 or send the request care form, which asks only for a name and phone number.
  2. Gateway talks with you about the wound, the address and the insurance.
  3. We confirm availability for that location and gather records for the treating clinician.
  4. The clinician visits, assesses the wound and writes the orders.
  5. We follow up on supplies, the next visit and communication with your other clinicians.

You do not need a confirmed diagnosis to start.

The nearest hospital to Glen Carbon is Anderson Hospital in Maryville, the next town south on Route 159. Gateway is not part of the hospital. The first days after a discharge are when questions come up about dressings, medications and who to call. A family member can contact Gateway to ask about follow-up, or the discharge planner can send a referral before the patient leaves. We request the hospital’s orders and summary, confirm the home or facility address, and arrange a visit with a partner clinician, who assesses the patient and sets the plan.

  • County: Madison County, Illinois
  • ZIP codes: 62034
  • Nearby hospitals: Anderson Hospital in Maryville (not affiliated with Gateway)
  • Nearby communities: Edwardsville, Collinsville, Madison County, Illinois, Granite City
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

More wound care in Glen Carbon

Read the full guide to diabetic foot ulcers, or see everything Gateway arranges on the mobile wound care in Glen Carbon page.

Common questions

Does Medicare or Medicaid pay for diabetic foot ulcer care in Glen Carbon?

We cannot say in advance. Coverage depends on the treating provider, your specific plan and the care that is ordered, and the rules for visits, dressings and offloading devices can differ. You can ask us about Medicare, Medicare Advantage, Medicaid and commercial plans. Gateway checks what it can with the provider and the plan before the first visit and tells you what we find.

What is Charcot foot, and is it related to foot ulcers?

Charcot foot is a condition in which the bones and joints of a numb foot weaken and shift, sometimes after a minor injury that was never felt. The foot may become red, warm and swollen with no open wound. As its shape changes, new pressure points form and ulcers can follow. It needs prompt evaluation, so report a suddenly swollen, warm foot to a clinician even if the skin is intact.

Will the clinician remove tissue from the wound during a visit?

Possibly. Removing callus and dead tissue, called debridement, is a common part of diabetic foot ulcer care, because unhealthy tissue hides the true size of the wound and can hold bacteria. Whether it is done, by what method and how often is up to the treating clinician, who considers blood flow first. Ask what to expect afterward, since a freshly cleaned wound can look larger.

Is Glen Carbon handled separately from Edwardsville?

Not really. The two communities share a border, and a request from Glen Carbon is handled the same way as one from Edwardsville. We take the address, confirm availability for that location and care setting, and arrange the visit with a partner clinician. If you are unsure which municipality your address falls in, the ZIP code (62034 for Glen Carbon) is enough for us to start.

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.