3 Signs of a Diabetic Foot Ulcer (Before It Becomes an Emergency)

In Grenada and across the Caribbean, diabetes-related amputations are heartbreakingly common. Many of these amputations could have been prevented if warning signs were caught earlier. A diabetic foot ulcer doesn't appear overnight—it develops through stages that, when recognized early, can be treated before becoming life-threatening.

If you have diabetes, learning to spot these early warning signs could save your foot. Here are the three critical stages to watch for.

Understanding Why Diabetic Foot Ulcers Develop

Before we cover the warning signs, let's understand why diabetics are vulnerable. This knowledge makes prevention more meaningful.

Neuropathy means you can't feel problems. High blood sugar damages nerves over time, often starting in the feet. You might step on something sharp, develop a blister, or have a shoe rubbing—and feel nothing. Pain is your body's alarm system; without it, damage goes unnoticed.

Poor circulation slows healing. Diabetes damages blood vessels, reducing blood flow to your extremities. Less blood means less oxygen, fewer healing nutrients, and fewer infection-fighting cells reaching your feet. A wound that would heal quickly for someone else takes weeks for you—if it heals at all.

Immune dysfunction makes infection more likely. Diabetics are more susceptible to bacterial infections, and those infections spread faster and are harder to fight.

These factors combine dangerously. An unnoticed injury + slow healing + infection vulnerability = the perfect storm for a diabetic foot ulcer.

Sign #1: A Red Spot That Won't Go Away

The very first stage of a diabetic foot ulcer is a persistent red spot on your foot—what medical professionals call a "pre-ulcer."

Here's how to identify it: Press your finger on the red area for five seconds, then release. In healthy skin, the area will briefly turn white (blanch) and then return to normal color within a few seconds. If the red spot doesn't blanch when pressed, or if it stays red for more than twenty minutes after you've removed pressure (like taking off a tight shoe), that's a warning sign.

This persistent redness indicates tissue damage beneath the surface. The skin isn't broken yet, but damage is occurring. It's most commonly found on the ball of the foot, the heel, the top of curled toes, or anywhere a shoe might rub.

What to do if you see this sign: Stop whatever is causing pressure on that area immediately. If it's a shoe issue, stop wearing those shoes. If it's from standing, stay off your feet. See a healthcare provider within two to three days if the redness doesn't resolve completely.

At this stage, a diabetic foot ulcer can still be prevented. The tissue can recover if you act quickly.

Sign #2: Broken Skin or a Shallow Wound

If the first stage is missed, the damaged tissue breaks down and the skin opens. Now you have an actual wound—a diabetic foot ulcer in its early stage.

This might look like a blister that has opened, a small crack in the skin especially on heels, a shallow wound with pink or red tissue visible, or an area where callused skin has broken down.

The danger at this stage is that diabetics often don't feel this happening. Without the pain signal, days or weeks can pass before you notice—giving the wound time to deepen and bacteria time to invade.

What to do immediately: Clean the wound gently with clean water or saline. Do not use hydrogen peroxide or iodine—these damage healing tissue. Cover with a clean, dry bandage. Keep pressure off the area. See a healthcare provider within twenty-four to forty-eight hours.

Do not try to "wait and see" at this stage. What looks like a minor wound on a diabetic foot can deteriorate rapidly. Professional assessment is essential.

Sign #3: Deep Tissue, Infection, or Spreading Redness

This is the emergency stage. A diabetic foot ulcer that has reached this point requires immediate medical attention.

Warning signs of a serious ulcer include wound that shows deep tissue (yellow, gray, or bone visible), redness spreading outward from the wound in streaks, warmth and swelling around the wound, foul smell or discharge, fever or feeling generally unwell, and black or dead-looking tissue.

This is not a "wait until Monday" situation. This is not a "try some bush medicine" situation. Deep diabetic foot ulcers can progress to gangrene or sepsis within days. People die from this—or lose limbs unnecessarily.

What to do at this stage: Go to a medical facility immediately. This might mean the emergency department. Bring any antibiotics you might have been prescribed. Be prepared to be admitted—serious ulcers often require IV antibiotics and surgical cleaning.

Diabetic Foot Ulcer Prevention: The Daily Habit That Saves Limbs

The single most effective way to catch diabetic foot ulcer warning signs is daily foot inspection. This takes two minutes and could save your leg.

Every evening before bed, sit down with good lighting and examine every part of both feet. Check the soles using a mirror or ask a family member to look. Look between every toe. Feel for areas of warmth or swelling. Look for any redness, cuts, blisters, cracks, or callus buildup.

If you can't see your feet well due to vision problems or flexibility issues, this is where family members become crucial. Someone else needs to check your feet for you.

Finding a small problem early allows treatment before it becomes a big problem. This simple daily habit is why some diabetics keep their feet for decades while others lose them within years of diagnosis.

What Makes Diabetic Foot Ulcers in Grenada Particularly Dangerous

Our climate and lifestyle create additional challenges for managing diabetic foot ulcer risk.

Humidity encourages infection. Bacteria and fungus thrive in our tropical environment. A wound that might stay clean in a dry climate becomes infected faster here.

Sandals and barefoot culture expose feet. Walking barefoot or in minimal footwear increases injury risk and exposes wounds to contaminated surfaces.

Healthcare access can delay treatment. Depending on where you live in Grenada, getting to specialized care might take time. This makes early detection even more critical—you need that head start.

Traditional remedies may delay proper care. While bush medicine has its place, a diabetic foot wound requires medical treatment. Delaying to try home remedies can allow a treatable wound to become a limb-threatening emergency.

Protecting Your Feet for Life

A diabetic foot ulcer doesn't have to be your story. With daily inspection, prompt attention to warning signs, and proper footwear and blood sugar control, many diabetics keep their feet for their entire lives.

Know the signs: persistent redness that won't blanch, any broken skin, deep tissue or spreading infection. Act quickly at each stage, and you dramatically improve your chances.

Your feet carry you through life. They're worth two minutes of attention every day.

Have you or a family member dealt with diabetic foot complications? What lessons did you learn that might help others? Share in the comments—your experience could help someone catch warning signs in time.