by Lee C. Ruotsi,
MD, FACCWS, UHM
What’s the big concern about diabetic foot ulcers? Here’s an
alarming statistic – your risk of dying within five years of developing a
diabetic foot ulcer is five times greater than that of prostate cancer and
twice more than breast cancer.
Currently, there are more than 25 million diabetics in our
country, with this number projected to double by 2025. Between 15-25 percent of
diabetics will develop foot ulcers, with 15 percent of those affected
eventually requiring a lower extremity amputation. In a recent study, people with diabetes-related foot ulcers
had a 47 percent increased risk of dying compared to those with diabetes alone.
The five-year mortality rate for patients with diabetic foot ulcers is about 45
percent, meaning that nearly half will die within five years.
Diabetes affects multiple organ systems, including the
vascular and central nervous system. To what extent, and the rate at which
problems develop, depends largely on how patients manage their diabetes. As the average level of blood sugar
rises, damage to the central nervous system and the vascular system becomes
more severe.
Diabetic neuropathy, a common diabetic condition that
primarily affects nerve sensations in the feet and legs, can impair walking and
the ability to sense pain and temperature. As the feet become less stable and
nerve sensation diminishes, wounds are likely to develop. Since diabetic
neuropathy affects circulation, as well as motor and sensory function, these
types of wounds are less likely to heal on their own.
Because diabetic foot ulcers are preventable and treatable,
it’s more important than ever to confront this deadly epidemic head on.
Children, adolescents and adults should undergo regular screening to detect
diabetes in its earliest stages when proper medical care and self-management
can prevent complications from developing.
Now that we know the problem, what’s the solution? Diabetics
must make a commitment to regular testing, appropriate medication regimens and
daily foot care. Physicians must renew their commitment to prevent diabetes by
educating patients on healthy exercise and eating habits, and through early
diagnosis and aggressive treatments to maintain healthy blood glucose
levels.
While the quest for a cure for diabetes moves forward in
research laboratories across the county, preventing and properly managing
diabetes is the key to lowering the complications and death rate among
diabetics. Patients must work together with their health providers using the
knowledge and tools we have to eat healthy, get regular exercise, control their
weight, and keep blood glucose levels in check. These things are imperative to
decrease their risk of diabetic neuropathy, and its inevitable endpoint, the
diabetic foot ulcer.
Should a diabetic foot ulcer develop, proper medical and
surgical care is crucial. As with all non-healing wounds, diabetic patients, in
conjunction with their primary care doctor or diabetes specialist, should seek
out the care of a wound healing specialist to treat problematic wounds before
serious complications occur.
About the Author:
Dr. Ruotsi is Medical Director
of the Catholic Health Advanced Wound Healing Centers, with locations in
Cheektowaga and Orchard Park; and devotes his clinical practice to the
treatment of wounds associated with diabetes and other medical conditions. For
more information, call 891-2750 (Cheektowaga) or 828-2330 (Or
