World Diabetes Day falls on 14 November, and many families in Malaysia are thinking about a parent or grandparent who lives with diabetes. Many families search in Malay with short, worried questions such as kenapa luka diabetes bau? (why does a diabetic wound smell?), as well as questions about wounds that are berair (weeping), bernanah (oozing pus), and even feet where maggots have been found.
This article explains in general terms why a diabetic wound can change in these ways, why infection tends to be more serious with long-standing diabetes, what family members can look out for, and which warning signs mean going to the emergency department. It is general knowledge only. Every wound is different, and only a doctor who examines it can assess what is happening.
Kenapa Luka Diabetes Bau? (Why Does a Diabetic Wound Smell?)
A wound that is closing well does not usually have a strong odour. When a foot wound in someone with diabetes starts to smell, becomes wet (berair) or produces thick yellow, green or cloudy fluid (bernanah, meaning with pus), this can point to infection, to damaged tissue in or around the wound, or to both. Pus is largely white blood cells and debris from the body’s fight against bacteria.
A change matters too: a dry wound that now weeps, a new smell, or a wound that looks larger, deeper or darker. There are several types of diabetic wounds, each with its own warning signs, and the look or smell alone cannot tell a family which is which. Only a doctor can assess the wound and the person’s overall health to work out the cause.
Bahaya Luka Diabetes (The Dangers of a Diabetic Wound): Why Infections Spread Faster, and What Sepsis Is
When blood sugar has been high for a long time, several changes can make a foot wound more dangerous (bahaya):
- Reduced feeling. Nerve damage (diabetic neuropathy) can mean a blister, cut or stone in the shoe is not felt, so a wound may go unnoticed for days.
- Reduced circulation. Narrowed blood vessels bring less blood, oxygen and the body’s own defences to the foot, which can slow healing and make infection harder to contain.
- A weaker immune response. Long-standing high blood sugar can affect how well white blood cells fight bacteria.
Together, these mean a diabetic foot infection can move from the skin into deeper tissue, and sometimes bone, more quickly than in someone without diabetes. The general warning signs of skin infection, such as redness, warmth, swelling and pain, can also be harder to notice when feeling is reduced.
In plain language, sepsis is when the body’s response to an infection goes into overdrive and starts to harm its own organs. It is a medical emergency, and an infected foot wound is one way it can begin in someone with diabetes.
Kaki Kencing Manis Berulat (Maggots in a Diabetic Foot): Often a Sign a Wound Went Unnoticed
Finding maggots (berulat) in the foot of someone with diabetes (kencing manis) is distressing, and families sometimes feel ashamed or assign blame. This is not a sign that anyone stopped caring. It usually means a wound went unnoticed for some time, often because of reduced feeling, poor eyesight, living alone, or feet that had become hard to reach or see. Flies are drawn to open, moist wounds.
Any wound with maggots needs prompt medical attention and is not something to manage at home. Kindness matters too, because a person who feels judged may hide the next wound.
Family members can often spot a problem first, for example:
- Stained socks, slippers or bedsheets, or fluid marks inside shoes
- A new or unusual smell from the feet, shoes or room
- A change in walking, such as limping or favouring one foot
- Reluctance to take off socks or shoes
- Swelling, or one foot looking a different colour from the other
None of these tells you what is wrong, but each is a good reason to have the foot looked at by a doctor.
Why Diabetic Foot Ulcers Can Come Back After the Skin Closes
Many diabetic foot ulcers do heal with appropriate medical care and follow-up, though it can take time. Yet ulcers often return after the skin has closed, because:
- Reduced feeling and reduced circulation are usually still present.
- Newly healed skin is thinner and more fragile.
- The same pressure points and footwear can cause the same damage again.
This is why a healed ulcer is often described as “in remission” rather than gone for good, and why follow-up continues after healing. Chronic and diabetic wounds belong to a field known as advanced wound care. A GP may assess a wound and may refer to a hospital or specialist team where needed.
Everyday Habits That Help Protect Diabetic Feet
Public health guidance broadly agrees on a few steady habits:
- A daily look at the feet, including between the toes and the soles; a family member or a mirror can help.
- Suitable footwear that fits well and does not rub, with a quick look inside shoes before wearing them.
- No barefoot walking, indoors or outdoors.
- Not smoking, since smoking further narrows the blood vessels in the legs and feet.
- Regular diabetes reviews, including foot checks, as advised by a doctor.
Red Flags: When to Go to the Emergency Department
Go to the nearest emergency department or call 999 straight away if a person with diabetes has a foot wound and any of the following:
- Fever, chills or shivering
- Confusion or unusual drowsiness
- Fast breathing or a racing heartbeat
- Redness, swelling or warmth spreading up the foot or leg
- A wound that suddenly smells, or skin that turns dark, grey or black
- Feeling extremely unwell
For a wound that is not healing, is weeping or looks different, it is sensible to see a doctor promptly.
Frequently Asked Questions
Kenapa luka diabetes berair? (Why is a diabetic wound weeping?)
A wound that keeps producing fluid can be linked to infection, inflammation, swelling in the leg, or tissue that is not healing well. Only a doctor who examines the wound can assess why it is weeping, so new or increasing wetness is a good reason to have it checked.
Apakah tanda luka diabetes infeksi? (What are the signs a diabetic wound may be infected?)
Signs can include increasing redness, warmth or swelling, pus or a foul smell (bau busuk), a wound getting bigger or darker, or feeling generally unwell. These signs do not confirm infection on their own; only a doctor can assess the cause.
Can a diabetic foot infection cause sepsis?
Yes. An infection that spreads beyond the wound can trigger sepsis, a medical emergency. Fever, chills, confusion or fast breathing alongside a foot wound means going to the nearest emergency department or calling 999.
Can diabetic foot ulcers heal?
Many do heal with appropriate medical care and regular follow-up, though it can take weeks or longer and ulcers can return. A doctor can explain what to expect for a particular wound.
Luka diabetes di kaki tidak sakit (a foot wound that does not hurt): is it still serious?
It can be. A lack of pain can sometimes be linked to reduced feeling in the feet, so a painless wound is not necessarily a minor one. It can still be infected or deep, and only a doctor who examines it can assess the cause, so it is worth having it looked at.
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