10 doctors weighed in:
In diabetic ulcers is it neuropathy or macrovascular disease that causes them? Can you get ulcers withouth macrovascular complications?
10 doctors weighed in

Dr. Scott Bolhack
Wound care
3 doctors agree
In brief: Diabetic ulcers
There are multiple concurrent causes of an ulcer in a diabetic that include: nerve problems, blood supply problems, and healing issues.
With blood supply problems they can be macrovascular (large vessels) and or microvascular (microscopic vessels). Either or both can be a factor in the complications and cause of ulcers associated with diabetics.

In brief: Diabetic ulcers
There are multiple concurrent causes of an ulcer in a diabetic that include: nerve problems, blood supply problems, and healing issues.
With blood supply problems they can be macrovascular (large vessels) and or microvascular (microscopic vessels). Either or both can be a factor in the complications and cause of ulcers associated with diabetics.
Dr. Scott Bolhack
Dr. Scott Bolhack
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Dr. Adam Ringler
Podiatry
1 doctor agrees
In brief: Diabetic ulcer
Diabetic ulcers can be caused by lateral circulation but most commonly are due to lack of sensation/neuropathy.
Because patient does not feel pain, they continue to walk on areas of the foot in which there is increased pressure. This eventually causes the skin to break down and ulcer to form. Both microvascular and macrovascular disease and complicate the ulcer healing process.

In brief: Diabetic ulcer
Diabetic ulcers can be caused by lateral circulation but most commonly are due to lack of sensation/neuropathy.
Because patient does not feel pain, they continue to walk on areas of the foot in which there is increased pressure. This eventually causes the skin to break down and ulcer to form. Both microvascular and macrovascular disease and complicate the ulcer healing process.
Dr. Adam Ringler
Dr. Adam Ringler
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Dr. Katharine Garnier
Family Medicine
1 doctor agrees
In brief: Some of both
It is often a combination of microvascular and neuropathic changes that causes diabetic ulcers.
Lack of sensation in the feet can mean that you don't get a warning about problems with your feet because you don't have normal pain or sensation to alert you. The microvascular problems with the small capillaries causes problems with the blood supply necessary to heal the small injuries that occur.

In brief: Some of both
It is often a combination of microvascular and neuropathic changes that causes diabetic ulcers.
Lack of sensation in the feet can mean that you don't get a warning about problems with your feet because you don't have normal pain or sensation to alert you. The microvascular problems with the small capillaries causes problems with the blood supply necessary to heal the small injuries that occur.
Dr. Katharine Garnier
Dr. Katharine Garnier
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Dr. Reid Blackwelder
Family Medicine
1 doctor agrees
In brief: Both can
Diabetes affects nerves by damaging the small blood vessels (micro vascular disease).
Numbness from neuropathy an lead to injuries which aren't felt. This is the most common cause of ulcers in diabetics. However, blockage of larger blood vessels (macrovas) can also lead to another knd of ulcer. Once someone has micro vascular disease from dm t s highly likely macrovasc disease is also present.

In brief: Both can
Diabetes affects nerves by damaging the small blood vessels (micro vascular disease).
Numbness from neuropathy an lead to injuries which aren't felt. This is the most common cause of ulcers in diabetics. However, blockage of larger blood vessels (macrovas) can also lead to another knd of ulcer. Once someone has micro vascular disease from dm t s highly likely macrovasc disease is also present.
Dr. Reid Blackwelder
Dr. Reid Blackwelder
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