Final answer:
Diabetic ulcers are not always painful due to diabetic neuropathy which can reduce pain sensation. Untreated, these ulcers may lead to serious infections and potential complications, requiring surgical intervention.
Step-by-step explanation:
It is false that diabetic ulcers are always extremely painful. Diabetic ulcers can sometimes be painless due to diabetic neuropathy, which can lead to numbness, tingling, and a reduction in pain sensation in the extremities. It is indeed a concern when diabetics such as Charles have a seemingly innocent scratch that develops into a non-healing ulcer, as diabetic ulcers can evolve into serious infections like gas gangrene caused by C. perfringens. Such complications are a significant concern for diabetic patients and can sometimes require surgical intervention, such as debridement, to prevent further infection and possible amputation.