Diabetic Foot Ulcer: Diabetic foot ulcer is an open sore or wound that occurs in approximately 15% of patients with diabetes and is commonly located on the bottom of the foot.

Example of a diabetic foot.


Diabetic foot ulcers usually begin with a foot injury, such as stepping on a nail or getting a blister from an ill-fitting shoe. This type of wound will typically heal on its own in people who do not have diabetes, but the situation is more complicated for those who do have diabetes.
Symptoms such as swelling, itching, and burning sensations can occur when a foot ulcer develops. However, if left untreated, it can deepen and worsen, resulting in serious complications. They are as follows:

  • Skin infections 
  • Gangrene
  • Sepsis
  • Foot deformities


When an ulcer develops on your foot or toe, you may notice changes in your skin such as:
  • Dry skin
  • Skin that is cracked
  • Scaly skin
  • Redness
  • Rashes

As the ulcer worsens, it can become wider, longer, and deeper, even reaching the bone. In advanced stages, you might notice:

  • A callus
  • A halo around the wound that feels harder than the skin around it
  • Drainage which indicates an infection
  • A brown discoloration
  • A strong odor


​Ulcers form as a result of a combination of factors, such as lack of feeling in the foot, poor circulation, foot deformities, irritation, trauma and diabetes. Additionally, when high blood sugar levels damage the nerves and blood vessels in the feet, foot problems can develop over time. Damaged blood vessels can cause poor blood flow in your feet thus, the infection may not heal properly. There are two diabetic foot ulcers that are caused either by neuropathic ulcer or vascular ulcer. 

Common pathways to foot ulceration.

Neuropathic ulcer
Diabetic patients who have had the disease for a long time may develop neuropathy, characterized by a reduced or complete inability to feel pain in the feet due to nerve damage. High blood sugar levels can damage sensory nerves, resulting in peripheral neuropathy, which causes altered or total loss of sensation and the inability to feel pain. Peripheral neuropathy develops in approximately 50% of diabetic adults, increasing the risk of foot injury from pressure, cuts or bruises.

Vascular ulcer
Vascular disease can aggravate foot ulcer by impairing healing and increasing the risk of infection. Long-term high blood sugar levels can also damage blood vessels, reducing blood flow to the feet (ischaemia) or skin (microangiopathy) which can lead to delayed wound healing. ​


Non-surgical Treatment Non-surgical Treatment

Surgical Treatment Surgical Treatment

A doctor will first attempt to treat diabetic foot problems without using surgery. Some methods include:

  • keeping wounds clean and dressed
  • prescribing antibiotics to treat infections
  • removing calluses
  • prescribing immobilization devices, such as a walking cast or total contact cast
  • closely observing any gangrene on the toes until self-amputation occurs, which is when the toes fall off due to lack of blood flow
  • recommending exercises and diet changes to manage peripheral vascular disease and prevent it from getting worse​

When nonsurgical treatment does not successfully heal diabetic foot problems, a doctor might consider surgery. Surgical options include:

  • removing decaying or dead tissue
  • removing ingrown toenails
  • amputating the affected limb, which may range from a single toe to the leg above the knee
  • surgically stabilizing Charcot Foot
  • performing an arterial bypass for peripheral vascular disease, which assists blood flow to the area
  • performing endovascular surgery with placement of stents, which are small devices that keep blood vessels open



CelltiMax is Mesenchymal Stem Cells (MSCs) derived from human umbilical cords. Upon treatment, the cultured cells are injected intramuscularly / intravenously into the patient.

​The cells are characterized by low immunogenicity. Hence, it is very safe, tolerable, and free of side effects. It has the capability to differentiate into specialized cells with specific functions for many parts of the body. They can reduce inflammation, repair, renew, regenerate, and replace damaged cells. 


Improve bodies’ natural healing abilities​

Modulate the immune system

Locate and reduce areas of inflammation

​Replace damaged and diseased cells


Figure 2 depicts the differentiation of stem cells and their therapeutic potential in healing diabetic foot ulcer.

Among the therapeutic mechanisms of stem cells in diabetic foot ulcer healing include:
  • Improved angiogenesis
  • Neutrophil proliferation
  • Fibroblast proliferation
  • Microphage generation
  • Cytokine production 


​If you feel we might be able to offer meaningful improvement to both your condition and your quality of life, then please reach out to schedule a free consultation with one of our in-house clinical experts. We offer consultations in both Malay and English. 

To schedule your consultation, click the button below

​During your consultation, we will: we will:

Review your medical history & recent evaluations

Explore what your treatment package might look like​

Answer any questions you have about us

Answer any questions you have about the therapies

Discuss practical next steps, ​if you feel we can effectively treat you

Review your medical history & recent evaluations

Explore what your treatment package might look like​

Answer any questions you have about us

Answer any questions you have about the therapies

Discuss practical next steps,
​if you feel we can effectively treat you