Wednesday, March 4, 2015

The Effect of a Diabetic Foot Ulcer on a Person's Life


            Diabetic feet are particularly susceptible to ulcers because of their inability to tolerate stress.   Poor glucose control damages nerves, tissues, blood vessels, tendons, ligaments, bone, and muscles. This can result in peripheral neuropathy, peripheral vascular disease, foot deformities, and consequent foot ulcers.  Motor neuropathy, damage to nerves supplying muscles, can result in muscle weakness and impair the ability to walk or stand (Holt, 2013).  Damaged nerves or sensory neuropathy can cause a decrease in the normal sensation of feet.  Therefore, trauma can easily occur to the feet because the inability to feel pain or pressure which can lead to a subsequent lesion.
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            Diabetic foot ulcers (DFU) cause a variety of problems negatively affecting an individual’s life.  DFUs, which are particularly slow to heal, have an increased chance of infection and tissue destruction (Benbow, 2012).  Ulcers allow pathogens to gain access, leading to infections that can threaten the limb or an individual’s life.  The single highest cause to non-traumatic limb amputations is diabetic foot ulcers (Brem, Sheehan, Rosenberg, Schneider, & Boulton, 2006).  Amputations have a higher mortality rate than colon or breast cancer within 5 years after receiving an amputation (as cited in Holt, 2013).

                                                                              

            Amputations and DFU limit mobility, activity level, and in some cases, the person’s ability to work, which has significant financial implications (Holt, 2013).  Although many diabetics experience an extreme decrease in sensation in their feet, up to 30% must cope with chronic pain or burning feeling due to damaged nerve pathways (Bloomgarden, 2007).  Chronic pain can lead to disruptions in sleep patterns, which can exacerbate glucose control and neuropathy.  Poor mobility, pain, low self-esteem and depression have been connected to a lower quality of life for many experiencing DFUs (Holt, 2013). 

            The best treatment for a DFU is prevention and early intervention.  Annual professional foot exams, therapeutic footwear and insoles, close glucose control and smoking cessation are recommended for all diabetic individuals.  DFUs should be taken seriously and can have negative consequences on quality of life as well as longevity.

Video 1: dangerous diabetic foot ulcers




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References
Brem, H., Sheehan, P., Rosenberg, H., Schneider, J., & Boulton, A. (2006). Evidence-based protocol for diabetic ulcers. Plastic and Reconstructive Surgery, 117(7), 193s-211s.http://dx.doi.org/10.1097/01.prs.0000225459.93750.29.
Benbow, M. (2012). Diabetic foot ulcers. Journal of Community Nursing, 26(5), 16. http://eds.b.ebscohost.com.p.atsu.edu/eds/pdfviewer/pdfviewer?vid=11&sid=b03c38e4-532b-4f40-a81f-4a4c583d5699%40sessionmgr111&hid=114.
Bloomgarden, Z. (2007). Diabetic retinopathy and diabetic neuropathy. Diabetes Care, 30(3), 760-765. http://dx.doi.org/10.2337/dc07-zb03.         
CNN. (2011, June 29). Dangerous diabetic foot ulcers [Video file]. Retrieved from http://www.youtube.com/watch?v=_TkJcM3C9sA
Holt, P. (2013). Assessment and management of patients with diabetic foot ulcers. Nursing Standard, 27(27), 49-55. http://dx.doi.org/10.7748/ns2013.03.27.27.49.e7284

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