Prophylactic Care: Preventing Diabetic Foot Ulcers through Regular Massage with Foot Care Cream

Introduction Preventing diabetic foot ulcers:

With approximately 4 crore diabetics in India, accounting for about 19% of the global diabetic population, the management of diabetes-related complications has become a significant healthcare challenge. Among these complications, diabetic foot ulcers are particularly devastating, leading to over 50,000 leg amputations every year in India alone. This article aims to shed light on the classifications of diabetic foot ulcers, emphasizing the importance of understanding their pathogenesis and the need for effective management strategies. Preventing diabetic foot ulcers is crucial for maintaining foot health and overall well-being. Through proactive measures such as regular foot care, massage, foot hygiene, proper footwear, maintaining good blood sugar control and seeking timely medical attention, individuals can significantly reduce the risk of developing diabetic foot ulcers and their potentially devastating consequences.

The Impact of Diabetes on the Feet:

Diabetes presents a significant burden on individuals and healthcare systems, with its classical complications affecting both microvascular and macrovascular systems. However, one of the most severe consequences of diabetes is foot ulceration. Even minor injuries to glucose-laden tissues in individuals with diabetes can lead to chronic infections and the formation of ulcers. In fact, diabetes mellitus (DM) is the leading cause of non-traumatic lower extremity amputations. This highlights the urgent need to address diabetic foot ulcers and develop effective management strategies.

Understanding the Pathogenesis of Diabetic Foot Ulcers:

Diabetic foot ulcers result from a complex interplay of various factors. High blood glucose levels in individuals with diabetes can lead to peripheral neuropathy, which affects sensation and can mask the perception of pain or injury in the feet. Additionally, diabetes-related vascular complications, such as reduced blood flow and impaired wound healing, further contribute to the development of ulcers.

Types of Diabetic Foot Ulcers:

Diabetic foot ulcers can be classified into several types based on their underlying causes and characteristics. The most common types include neuropathic ulcers, ischemic ulcers, and neuro-ischemic ulcers. Neuropathic ulcers are primarily caused by peripheral neuropathy and are often painless. They commonly occur over pressure points on the foot, such as the heel or metatarsal heads. Ischemic ulcers, on the other hand, result from inadequate blood supply to the foot, often due to underlying peripheral artery disease. Neuro-ischemic ulcers occur in individuals with both neuropathy and reduced blood flow and combine features of both neuropathic and ischemic ulcers.

Depth Ischemia Classification of Diabetic Foot Ulcers:

The depth and severity of diabetic foot ulcers play a crucial role in determining appropriate management strategies. A widely used classification system is the Wagner classification, which categorizes ulcers into six stages based on their depth:

Stage 0: No open ulcer but presents with deformity or cellulitis.

Stage 1: Superficial ulcer involving the epidermis or dermis.

Stage 2: Ulcer extends to deeper tissues, such as tendon, bone, or joint capsule.

Stage 3: Deep ulcer with abscess or osteomyelitis.

Stage 4: Gangrene of the toes or forefoot.

Stage 5: Extensive gangrene affecting the whole foot.

Understanding the depth ischemia classification helps healthcare professionals assess the severity of the ulcer and determine the most appropriate treatment approach, which may range from offloading and wound care to surgical interventions.

Management of Diabetic Foot Ulcers:

The management of diabetic foot ulcers should primarily focus on prevention and comprehensive care. Prevention involves regular foot examinations, proper foot hygiene, appropriate footwear, and patient education. Prophylactic skin care and nail care are essential components of managing foot health.

Strict glycemic control is paramount, as it helps minimize the risk of complications and facilitates better wound healing. Individuals with diabetes should work closely with their healthcare team to maintain target blood glucose levels.

Proper nutrition plays a vital role in wound healing and overall foot health. A balanced diet, rich in essential nutrients, can support tissue repair and boost the immune system. Adequate protein intake is particularly important for promoting wound healing.

Regularly massaging with diabetic foot care cream can help preventing diabetic foot ulcers in several ways:

Moisturization: Diabetic foot care creams are specially formulated to moisturize the skin, which is crucial for preventing dryness and cracking. Regularly massaging the cream onto the feet helps maintain the skin’s moisture balance, reducing the risk of developing cracks or fissures that can lead to ulceration.

Enhanced Circulation: Massaging the cream onto the feet stimulates blood circulation. Improved blood flow helps deliver oxygen and essential nutrients to the tissues, promoting overall foot health. Proper circulation is crucial for preventing complications associated with reduced blood flow, such as ischemic ulcers.

Skin Integrity: A good diabetic foot care creams often contain ingredients that support skin integrity and strengthen the skin’s natural protective barrier. Massaging the cream onto the feet helps these beneficial ingredients penetrate the skin, providing an added layer of protection against injuries and infections that can lead to ulceration.

Sensory Stimulation: Massaging the feet with the cream can provide sensory stimulation, which is particularly important for individuals with peripheral neuropathy. Regularly stimulating the feet through massage helps improve sensory awareness, allowing individuals to detect potential issues such as pressure points or abnormalities in their feet, and take appropriate preventive measures.

Relaxation and Stress Reduction: Massaging the feet with diabetic foot care cream can offer relaxation and stress reduction benefits. Managing stress is essential for individuals with diabetes as high stress levels can negatively impact blood sugar control. By incorporating regular foot massage into their self-care routine, individuals can help maintain their overall well-being and potentially reduce the risk of complications such as foot ulceration.

Diabetic Foot Care Cream

One such product, Bionova’s Cozysoft cream, has shown to be useful in the prophylactic care of diabetic feet. This cream is specifically formulated and contains L-Arginine as main ingredient, this not only helps to moisturize and nourish the skin, but also protecting it from dryness and cracking, improving blood circulation. This cream is not a medicine to cure wounds, but it is a massaging foot care cream for prophylactic care.

L-Arginine, an amino acid, is renowned for its vasodilatory effects, enhancing blood vessel widening and boosting blood circulation. In the context of diabetic foot ulcers, impaired blood circulation is a common issue. Massaging with L-Arginine-infused cream boosts blood flow, improving oxygen and nutrient delivery to the feet. Massaging foot regularly with Cozysoft cream will also help in maintaining foot hygiene routine & relaxation of stressed feet.


Diabetic foot ulcers are a major health risk for those with diabetes, demanding careful management to prevent severe complications. Properly addressing them is vital, as complications, including amputations, can result from inadequate care for diabetic foot ulcers. Understanding diabetic foot ulcer classifications is crucial for improving outcomes and reducing the burden of this condition. Knowing the pathogenesis of these ulcers is essential in the quest for better management strategies. Implementing comprehensive strategies becomes pivotal for effective management and positive outcomes in diabetic foot ulcer cases.