By Lance Johnson, DPM
Blanchard Valley Orthopedics & Sports Medicine
Diabetes mellitus (diabetes) is an epidemic that results in numerous complications, hospitalizations and deaths worldwide. Diabetes occurs when your body is not able to process and use glucose (sugar) from food. This results in too much glucose accumulating in your blood stream. This can have negative effects on many different organs and parts off your body.
425 million people across the globe have diabetes and there are several different causes and types. Every seven seconds someone in the world dies from diabetes. Diabetes can lead to complications across multiple organs and parts of the body including the eyes, kidneys, heart and feet. One of the most feared and devastating of these complications are diabetic foot infections. Diabetes can result in decreased sensation in a patient’s feet (also known as peripheral neuropathy). This decrease in sensation can lead to open wounds or sores (ulcers) on the bottom of a patient’s foot. Diabetes can also lead to hardening of the arteries in the entire body, including the legs and feet. The hardening of the arteries in the legs and feet in combination with plaque formation (atherosclerosis) can lead to decreased circulation or blockages in the blood flow to a patient’s feet (ischemia). Diabetes can also result in decreased immune response making patients more susceptible to infections via decreased sensation, poor circulation and compromised immune systems.
Once infection occurs, it can spread rapidly causing death of the surrounding tissues and bone. Infection can also spread into the bloodstream, which can result in sepsis, shock and even death. Some infections can even put patients at risk for partial foot amputation or major/entire amputation of the foot. Every 20 seconds someone in the world undergoes an amputation.
The lifetime risk of patients with diabetes to develop a foot ulcer is 34 percent. More than 50 percent of diabetic foot ulcers become infected and 20 percent of diabetic foot infections will result in amputation. Subsequently, the chance of death within five years of an amputation in a patient with diabetes is 68 percent. Amputation of the lower limb can also lead to decreased independence, decreased mobility, negative social stigma and negative emotional/psychological effects.
Treatment for diabetic foot infections often involve antibiotics, hospitalization and sometimes surgical removal of the infected tissue and reconstruction of the foot. Prevention of infections is key to preventing these life and limb threatening complications.
For patients with diabetes, it is imperative that they keep their blood sugars well controlled, check their feet daily, follow up with a diabetes specialist or primary care physician and see a foot and ankle specialist regularly. This is especially important for a patient that has risk factors such as heart disease, vascular disease, kidney disease and smoking.
