A Summary: The Initiative to Reduce Diabetic Foot Ulcers Blog

Avoiding Diabetic Foot Ulcers: What You Can Do About Them.

            Currently, 9.3% or 21.9 million people have diabetes (CDC, 2014 ). The Center For Disease Control (CDC, 2014), estimates that in the United States, approximately 8.1 million people are currently undiagnosed.  Who should be interested in the topic of diabetic foot ulcers? You should, especially if you fit into one of these categories.

            The purpose of this blog is to educate patients with diabetes as well as family members and/or caretakers regarding the significance of diabetic foot ulcers.  Diabetes is most familiar as it relates to obesity. There is also a distinct familiarity with the co-morbidity of heart disease which is directly linked to a deficient diet and sedentary lifestyle. The risk of death for a person with diabetes is twice that compared to a person of similar age and background without diabetes (ADA, 2014).

            Accordingly, an increase in mortality can be expected due to (a) large vessel disease, which includes heart attack and strokes, (b) small vessel disease, which includes the risk of retinopathy and neuropathy, and (c) nerve damage that primarily affects the lower extremities (MNT Knowledge Center, 2015). In the foot, nerve damage can be discernible through tingling, burning sensations, or shooting pain. Unfortunately, it is also possible to be completely asymptomatic.  Over time, the ability to feel pain is diminished and  it is possible for injuries to the feet to go unnoticed.

            Nerve damage, a serious complication of diabetes due to uncontrolled blood sugar levels, is a primary cause of diabetic foot ulcers. In the United States, over half of all amputations are caused by a diabetic foot ulcer (Amputee Coalition Fact Sheet, 2008). A person with diabetes has a 15-25% lifetime risk of developing a lower extremity wound (Braun, Fisk, Lev-Tov, Kirsner & Isseroff, 2014).

            In 14-24% of cases in the United States, an ulcer will become serious enough that amputation will be necessary to save the limb (American Podiatry Medical Association, 2015). In 85% of the cases, a diabetic foot ulcer precedes the related amputation (American Podiatry Medical Association, 2015). The risk of death after an amputation approaches 50% at the 5 year mark (Braun et al., 2014).  Surviving an amputation means incurring tremendous economic burden with the three-year cost of surgery and amputation approaching $60,000 due to the need for home care and social services (Hinkes, 2009). A person suffering complications of diabetic foot ulcers may experience added rehabilitation costs, prosthesis expenses, time lost from work and disability. These are factors that demand a lifetime of repercussions.

            Diabetic foot ulcers are largely preventable. Patient education, blood glucose control and infection control are all key parts of avoiding complications from foot wounds associated with diabetes  (Braun et al., 2014). The goal of this blog is to allow patients with diabetes to become active members of the health care team and work cooperatively with their health care provider to reduce the incidence and burden of diabetic foot ulcers.

            While anyone with diabetes can develop a foot ulcer, knowing how adverse health issues become problematic can reduce the incidence. High blood pressure, high cholesterol levels and poor blood glucose levels greatly contribute to diabetic foot ulcers. Smoking, excessive alcohol intake and a compromised immune system also factor in. Poor circulation, foot deformity, such as a bunion or hammer toe, or previous history of a diabetic foot ulcer are also considered high risk (American Podiatry Medical Association, 2015).

             Keeping nails appropriately trimmed, making sure shoes fit properly, avoiding walking barefoot and having a foot examination at least once a year are beneficial. Maintaining a healthy weight and participating in some form of exercise are extremely useful. Please take the opportunity to know your risks. Learn what you can do to retain good health by exploring the importance of an annual foot exam and know why it should matter to you.

References

American Diabetes Association (2014).  Statistics about diabetes.  Retrieved from http://www.diabetes.org/diabetes-basics/statistics/

American Podiatry Association. (2015 ). Diabetic wound care. Retrieved from http://www.apma.org/Learn/FootHealth.cfm?ItemNumber=981

Amputee Coalition Fact Sheet. (2008). Diabetes and lower extremity amputations. Retrieved from http://amputee-coalition.org/fact_sheets/diabetes_leamp.html

Braun, L., Fisk, W., Lev-Tov, H., Kirsner, R., & Isseroff, R. (2014). Diabetic foot ulcer: An evidence-based treatment update. American Journal of Clinical Dermatology, 15(3), 267-281. http://dx.doi.org/10.1007/s40257-014-0081-9

Centers for Disease Control and Prevention (2014).  National diabetes statistics report. Retrieved from http://www.cdc.gov/diabetes/pubs/statsreport14/national-diabetes-report-web.pdf.

Hinkes, M. (2009).  Diabetes: Taking steps to prevent amputation.  Retrieved from http://lermagazine.com/article/diabetes-taking-steps-to-prevent-amputation

MNT Knowledge Center. (2015). What is neuropathy? Neuropathy causes and treatments. Retrieved from: http://www.medicalnewstoday.com/articles/147963.php

Wound Resource. (2015). At-risk patient: Diabetic foot ulcers. Retrieved from http://www.woundsource.com/patientcondition/risk-patient-diabetic-foot-ulcers