Preventing Diabetic Foot Ulcers: Foot Care & Offloading Tips for South Texans

Foot ulcers are the most common cause of non-traumatic lower-limb amputations in the U.S. and they nearly always start small. In fact, according to the American Diabetes Association, over 85% of diabetes-related amputations begin with an ulcer. But here’s the truth: most diabetic foot ulcers (DFUs) are preventable with the right foot care, early intervention, and support.

At Hill Country Wound Care & Hyperbarics, we treat diabetic wounds every day, but we’d much rather help you avoid one altogether. If you’re living with diabetes in San Antonio or South Texas, this guide is for you.

Why Diabetic Foot Ulcers Happen

High blood sugar levels over time can damage:

● Nerves (neuropathy) — leading to loss of feeling in the feet

● Blood vessels (vascular disease) — reducing circulation

● Immune response — increasing risk of infection

When a patient with neuropathy develops a small blister, burn, or scrape, they may not notice it. And if circulation is poor, the skin doesn’t heal normally. This creates the perfect storm for an ulcer to form, and worsen quickly.

That’s why foot ulcers aren’t just skin wounds. They’re systemic complications of diabetes, requiring thoughtful prevention and care.

1. Start with a Daily Foot Check

If you have diabetes, especially if you’ve lost feeling in your feet, this is non-negotiable.

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Every day, inspect your:

• Heels and soles
• Toes and toenails
• Sides and tops of the feet

Look for:

• Red spots, blisters, or scratches
• Cracks, calluses, or thickened skin
• Drainage, swelling, or odor
• Any area that’s unusually warm, cool, or discolored

Pro Tip: Can’t reach your feet? Use a hand mirror or ask a family member to help. Many patients we see at Hill Country caught early warning signs just by looking daily.

2. Never Go Barefoot, Even at Home

In warm climates like San Antonio, it’s common to go barefoot or wear flip-flops around the house, on patios, or at the beach. But this exposes your feet to:

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• Burns from hot pavement or decks
• Cuts from glass, gravel, or thorns
• Punctures from splinters or nails

All it takes is one unnoticed injury to start a dangerous ulcer.

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Instead:

• Wear closed-toe slippers or diabetic-safe shoes indoors
• Use protective sandals with toe shields at the pool
• Avoid walking barefoot on any outdoor surface

3. Choose Shoes That Protect, Not Just Fit

Poor footwear is one of the top contributors to DFUs. Tight shoes, high heels, or sandals with straps can create pressure points that lead to tissue damage.

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What to Wear:

• Closed-toe shoes with plenty of room
• Soft inner linings without seams
• Rocker soles or cushioned insoles to reduce pressure
• Custom orthotics (when prescribed)

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What to Avoid:

• Flip-flops or open sandals
• High heels or narrow toe boxes
• Stiff, unpadded interiors

4. Understand and Use Offloading Properly

“Offloading” means relieving pressure on high-risk areas of the foot, especially over bony spots like:

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• The ball of the foot (metatarsal heads)
• The heel
• The big toe or lateral foot edge

Even standing or walking in your own home can cause repetitive stress injuries if the pressure isn’t redistributed.

Preventive Offloading Tools:

• Custom inserts or orthotics for daily shoes
• Wound shoes or pressure-relieving footwear
• Toe spacers or foam padding to prevent rubbing

For those with early-stage or healing ulcers, we may prescribe:

• Removable boots (CAM walkers)
• Total contact casts (TCCs)
• Custom braces

Our clinics also offer ultrasonic debridement, biologic dressings, and HBOT for patients with pre-ulcerative signs like calluses, redness, or fragile skin.

5. Keep Blood Sugar Under Control

No matter how meticulous your foot care routine is, it won’t be enough if blood glucose is consistently elevated.

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High blood sugar:

• Impairs circulation
• Weakens immune defenses
• Slows new tissue growth

We recommend working with your endocrinologist or primary care provider to keep your A1C in target range and monitor blood sugar daily. This is your foundation.

6. Moisturize the Right Way

Dry, cracked skin is an open invitation for infection. Apply unscented moisturizer to the tops and bottoms of your feet daily, but avoid lotion between the toes, where moisture buildup can lead to fungal infections.

7. Know When to See a Specialist Before You Have an Ulcer

Many patients wait until an ulcer appears before seeking care. But at Hill Country, we help prevent DFUs by treating:

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• Pre-ulcerative calluses
• Red pressure spots
• Early signs of skin breakdown
• Poor foot biomechanics
• Recurring “hot spots” from improper footwear

If you have neuropathy, a foot deformity, previous ulcers, or vascular disease, schedule a preventive foot evaluation with our team.

South Texas-Specific Risk Factors

Living in our region brings unique risks for diabetic feet:

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• Heat & humidity: Increase sweat, fungus risk, and likelihood of barefoot exposure
• Outdoor culture: Yardwork, gardening, barbecues = more chances for unnoticed foot trauma
• Footwear choices: Flip-flops and sandals offer little protection but are worn year-round

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We help patients across Bulverde, Live Oak, and Southwest San Antonio stay active while protecting their feet for the long haul.

Prevention Is Powerful But It Takes a Team

Preventing diabetic foot ulcers requires daily effort, smart decisions, and expert backup. At Hill Country Wound Care, we walk alongside high-risk patients to stop ulcers before they start.

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What We Offer: 

• ✅ Preventive foot assessments
• ✅ Access to offloading tools and footwear referrals
• ✅ Guidance on proper foot hygiene and pressure relief
• ✅ Full wound care services if problems arise
• ✅ Board-certified wound care physicians and advanced technology at every location

Ready to Stay One Step Ahead?

Don’t wait for a wound to appear! Request a Preventative Foot Consultation.