HealthNotes: Blog Edition

Diabetes and Diabetic Foot Ulcers

November 7, 2018

November is Diabetes Awareness Month

According to the CDC, an estimated 30.3 million people in the United States (9.4 percent of the population) have diabetes, which includes 7.2 million who are unaware they are living with the disease. The percent of adults with diabetes increases with age, reaching a high of 25.2 percent among those aged 65 years or older. In addition to age, risk factors for diabetes also include diet, activity level, obesity and heredity.

Diabetes may be accompanied by other co-existing conditions such as blindness, heart disease, kidney failure or lower-limb amputations.

High blood sugar levels, poor circulation, immune systems issues, nerve damage and infection may contribute to a non-healing diabetic foot ulcer. Approximately 25 percent of people living with diabetes will develop a foot ulcer. Diabetic foot ulcers have an alarming high recurrence rate. As many as 40 percent of people with a healed diabetic foot ulcer will develop a new ulcer within a year. Diabetic foot ulcers can be challenging to heal and its estimated 14-24 percent of people with foot ulcers will experience an amputation. Even more alarming, people with an amputation have a 50 percent mortality rate within five years.

There are several common factors of diabetic foot ulcers including neuropathy (disease of the nervous system), peripheral arterial disease (PAD), deformities and Charcot foot. Neuropathy is a result of damage to peripheral nerves and often causes weakness, numbness and pain in hands and feet. Similarly, PAD is caused by narrowed arteries which reduces blood flow to the limbs. Charcot foot is a deformity that results from nerve damage in the foot or ankle, which may cause injuries to go untreated, leading to the breakdown of joints.

Frisbie’s Wound Center recommends the following to help prevent diabetic foot ulcers:

  • Stop smoking immediately
  • Comprehensive foot examinations each time you visit your healthcare provider
  • Daily self-inspections of the feet, or have a member perform the inspection
  • Regular care of the feet including cleaning toenails and taking care of corns and calluses
  • Choose supportive, proper footwear (shoes and socks)
  • Take steps to improve circulation such as eating healthier and exercising on a regular basis

Proper wound care techniques are imperative to healing diabetic foot ulcers such as debridement, offloading or total contact casts (TCC), negative pressure wound therapy and hyperbaric oxygen therapy (HBOT). Debridement, the removal of damaged tissue, is widely recognized as one of the most important methods of advanced wound care. Total contact casting, also known as off-loading, relieves pressure from the wound and is the gold standard for the treatment of diabetic foot ulcers. Finally, hyperbaric oxygen therapy uses specially designed chambers to increase the amount of oxygen in the bloodstream, which then accelerates the body’s natural healing process. This is used to treat problematic, non-healing wounds. HBOT helps heal the wound from the inside out. It is also effective in fighting certain types of infections, improving circulation, stimulating growth of new blood vessels, and treating crush injuries, and diabetic wounds of the lower extremities. These specialized care therapies can aid in wound closure, new tissue growth, and wound tissue regeneration.

To find out if you’re a candidate for specialized wound care, visit the Wound Care Center page.

For more information about diabetes, visit the CDC website or the American Diabetes Association website.

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