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.
What an assessment covers
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 Lake St. Louis
From Lake St. Louis, a wound center, a vascular lab or a podiatry office can be a long drive each way, and that drive usually depends on a family member taking time off work. Home visits for a diabetic foot ulcer cut down on those trips. When the adult child who helps with dressings commutes, the treating clinician can set a schedule around it, such as evening changes, or order home health nursing for the daytime. Gateway sends visit updates to the family contact you choose, so a caregiver at work can stay informed without being in the room.
Two lakes shape daily life in Lake St. Louis. The city was planned around them in western St. Charles County, in the stretch between Interstate 70 on the north and Interstate 64 on the south, with Wentzville to the west and O’Fallon to the east. It started as a lake community and still draws people who want to retire near the water. Many residents are older adults, and some live alone. Wound care and primary care that come to the home help them stay where they are.
When care happens at home
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.
Changes to report
Whoever changes the dressing is well placed to spot trouble. Let the treating clinician know if you see any of the following:
- Drainage soaking through sooner than it used to
- The wound measuring larger, or new openings nearby
- Skin around the wound turning white, soggy or raw
- A new blister or rubbed area where the boot, cast or shoe touches
- Fresh blood on a dressing that used to come off clean
Bleeding that will not stop with firm pressure, sudden weakness, slurred speech or difficulty breathing are reasons to call 911, not to wait for a call back.
How primary care fits in
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.
How to get started in Lake St. Louis
People asking about diabetic foot ulcer care in Lake St. Louis usually want to know what the first visit involves. Before it, Gateway collects the records the treating clinician asks for and confirms the time and place with you. During it, the clinician looks at the wound and the skin around it, measures it, asks about your health and medications and explains what they recommend. Afterward, the orders go to whoever does the daily care, supplies are requested and a follow-up is planned. Our guide to how mobile wound care visits work has more. To begin, call 314-325-0126. Whether a visit can be arranged is confirmed for your location.
SSM Health St. Joseph Hospital in Lake Saint Louis is the closest hospital for most residents, and Progress West Hospital in O’Fallon is a short drive east. Neither is affiliated with Gateway. When a patient is being discharged with a surgical wound, a pressure injury or a leg ulcer, the family or the hospital case manager can contact us to ask about follow-up at the Lake St. Louis address. A fax to 314-786-7966 with the discharge summary and wound orders gives the treating clinician what is needed to plan a first visit.
- County: St. Charles County, Missouri
- ZIP codes: 63367
- Nearby hospitals: SSM Health St. Joseph Hospital in Lake Saint Louis; Progress West Hospital in O'Fallon (not affiliated with Gateway)
- Nearby communities: Wentzville, O'Fallon, Missouri, Dardenne Prairie, St. Charles County
- Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation
Other conditions and nearby communities
Read the full guide to diabetic foot ulcers, or see everything Gateway arranges on the mobile wound care in Lake St. Louis 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 Wentzville
- Diabetic foot ulcer care in O'Fallon
- Diabetic foot ulcer care in St. Charles County
Common questions
Does Medicare or Medicaid pay for diabetic foot ulcer care in Lake St. Louis?
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 shoes should I wear once the ulcer has closed?
Footwear after closure is a medical decision more than a shopping one. Many people are measured for shoes and inserts made for diabetic feet, usually through a podiatrist or a footwear specialist on a clinician’s order. Going back to the shoes worn before the ulcer is a common reason wounds return. Ask the treating clinician when and how to move out of the offloading device.
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.
Is Lake St. Louis within the area where Gateway arranges home visits?
Yes. Gateway arranges wound care and primary care in Lake St. Louis and across St. Charles County, including Wentzville, O’Fallon and Dardenne Prairie. Because the city is on the western side of the region, availability is confirmed for each address and care setting before anything is scheduled. Call 314-325-0126 with the address and we will tell you what can be arranged.
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.