People living with diabetes may experience skin and circulation problems that make wounds more likely to develop and slower to heal. Ulcers on legs from diabetes can range from shallow wounds to deeper sores that require specialist treatment. Understanding why these ulcers occur, how to recognise warning signs, and when to seek care can help reduce the risk of infection and tissue damage.

Why Does Diabetes Cause Leg Ulcers?

Diabetes can affect the nerves and blood vessels responsible for protecting the skin and supporting wound healing.

One possible cause is peripheral neuropathy, a form of nerve damage that reduces sensation. A person may not notice a scratch, blister, or pressure injury until it becomes a larger wound.

Another cause is peripheral artery disease, which reduces blood flow to the legs and feet. When circulation is poor, damaged tissue may receive less oxygen and fewer nutrients, making healing more difficult.

Some people develop ulcers because of a combination of nerve damage, poor circulation, pressure, and infection risk.

What Do Diabetic Leg Ulcers Look Like?

The appearance of an ulcer depends partly on its cause and location. It may look like an open sore, a shallow crater, or a wound with damaged tissue. The surrounding skin may be red, swollen, dry, discoloured, or unusually warm.

Some ulcers produce fluid or have an unpleasant smell. Others may be relatively painless because nerve damage reduces sensation.

A wound that does not improve, repeatedly reopens, or becomes deeper should not be ignored. Dark or black tissue, rapidly spreading redness, or a sudden change in the appearance of the leg requires urgent medical assessment.

Common Locations and Risk Factors

Diabetic ulcers often affect the feet and toes, but lower-leg ulcers can also occur. Their location may provide clues about the underlying problem.

Ulcers associated with poor arterial circulation may develop on the feet, toes, or areas exposed to pressure. Venous ulcers, which are associated with problems returning blood from the legs to the heart, often develop around the lower leg or ankle. Diabetes may coexist with either condition.

Additional risk factors include poorly controlled blood glucose, previous foot ulcers, reduced mobility, unsuitable footwear, smoking, and a history of vascular disease.

How Are Leg Ulcers Treated?

Treatment begins with an assessment by a qualified healthcare professional. The clinician may examine the wound, evaluate sensation and circulation, and check for signs of infection.

Depending on the findings, treatment may include:

Wound care: Appropriate cleaning, dressings, and removal of unhealthy tissue when indicated.

Pressure reduction: Special footwear or offloading devices may help prevent further damage to certain foot ulcers.

Circulation assessment: Tests may be needed to determine whether reduced blood flow is preventing healing. Some patients benefit from specialist vascular treatment.

Infection management: An infected ulcer may require antibiotics or hospital care, depending on its severity.

Diabetes management: Improving blood glucose control can support the body's ability to heal.

Compression therapy may be appropriate for some venous ulcers, but it should only be used after a healthcare professional has assessed circulation and confirmed that it is suitable.

How to Reduce the Risk of Future Ulcers

Check your feet and lower legs daily for cracks, blisters, swelling, colour changes, and open wounds. Wear comfortable, properly fitting footwear and avoid walking barefoot.

Keep your skin clean and moisturised, but avoid applying moisturiser between the toes if it causes persistent dampness. Do not attempt to remove corns or calluses with sharp tools or chemical products.

Attend routine diabetes reviews and seek advice about foot examinations, circulation, and safe physical activity.

When to Seek Medical Attention

If you have diabetes and notice a new open wound on your foot or leg, arrange prompt medical assessment. Do not wait for pain to develop. Fever, spreading redness, pus, blackened tissue, or rapid deterioration requires urgent care.

Conclusion

Ulcers on legs from diabetes may develop because of nerve damage, poor circulation, pressure, or a combination of these factors. Early assessment and appropriate treatment can help prevent complications. Regular skin checks, suitable footwear, professional diabetes care, and timely attention to wounds are essential for protecting leg and foot health.