A Brief Note On Diabetic Foot Ulcers And Diabetes

In the following case study, the author will discuss the issues surrounding a seventy-year-old female with a chronic neuropathic ulcer on the sole of her right foot and the rationale and implications of

People with diabetes also have a higher risk of developing foot ulcers that can take weeks or months to heal. Food choices and nutritional status influence wound healing since serious wounds increase the energy, vitamin, mineral and protein requirements necessary to promote healing. Most things can help your blood clot and you serious sores or cuts heal, When you have like a smell or oder example: a skunk you wash you body in tomato sauce to get the smell to fade away . When you want your teeth to grow strong or eyes to be clear you can eat certain thing to help them get stronger that's exactly how you can clear your skin from sores bumps and ect.

It is estimated that 387 million people, globally live with diabetes (Phillips & Mehl, 2015). According to Medical News Today [MNT], diabetes is a metabolic disorder; which causes patients to be extremely thirsty and produce a lot of urine. Diabetes arises due to high blood pressure, due to the body not being able to produce enough insulin or because the body does not respond well to high insulin levels (MNT, 2016). There are four types of diabetes; there is the pre-diabetic stage, type 1 diabetes, type 2 diabetes and gestational diabetes. In 2014, 29 million people died due to diabetes. This equates to 1 diabetic patient dying every seven seconds due to preventable complications (including complications affecting lower limbs) caused by diabetes. It is said that 20-40% of health care costs are spent on the treatment of lower limb complications due to diabetes. The risk of a diabetic patient developing a foot ulcer is 25% and foot ulcers account approximately 85% of lower limb amputations. Diabetic complications that affect lower limbs are caused by both type 1 and type 2 diabetes (Phillips & Mehl, 2015). It is said that the World Health Organization described diabetic foot syndrome as including all possible complications in relation to the feet of a diabetic patient. Diabetic foot syndrome is defined as the ulceration of the foot, from the ankle downwards. Causes of foot ulceration include peripheral sensory neuropathy, vascular disease (ischaemia) and infection

venous leg ulcers and diabetic foot ulcers. Canadian Association of Wound Care (CAWC) has published

Diabetes is a lifelong disease that can affect both children and adults. This disease is the sixth leading cause of death in the United States. It claims about 178,000 lives each year. Type one diabetes, also known as insulin dependent diabetes mellitus, usually occurs in people less than thirty years of age, but it also may appear at any age. Diabetes is a very serious disease with many life threatening consequences, but if it is taken care of properly, diabetics can live a normal life.

Diabetic Peripheral Neuropathy (DPN) is one of the most common microvascular complications in diabetes and can result in foot ulceration, ampuation and an impaired quality of life(Carrington AL, et al 2002,Boulton AJ,et al 2004). The reported prevalence of diabetic peripheral neuropathy ranges from 16% to as high as 66%2 and its prevelance is believed to increase with the duration of diabetes and poor glucose control.(Boulton AJ.et al 2000) It’s accounts for 50–75% of non-traumatic amputations in diabetic patients.(Holzer SE, et al 1998, Boulton AJM, 1998,Malay DS, et al 2006)

The number of people with diabetes is greatly increasing around the world. A large percentage of this population can be expected to develop diabetic foot ulcers. During the mid-19th century the problem of diabetic foot ulcers was discovered and discussed for the first time (Naves, 2016). In the mid-19th century, diabetic foot ulcers were treated by prolonged bed rest, although it was only a temporary fix because they started to notice that the ulcers would come back once they were back on their feet again. It is not until Frederick Treves (1853-1923), famous for performing the first appendectomy, suggested a different approach for the treatment of foot ulcers which is using sharp debridement of callus (Naves, 2016). After debridement, antiseptic

It is not until they have a sore, especially on the feet, that does not heal, that they seek out medical attention. Therefore, the importance of good hygiene and visualization is key when dealing with diabetes. Patients with sustained higher sugar levels are not able to heal properly and often have other comorbidities that affect the healing process. They have a number of problems in the way such as lack of proper knowledge. They sometimes are not aware that they have a sore and it’s often too late for healing because of the delay in seeking medical treatment and the damage is already done. This often leads to have to undergo either a vigorous role of intravenous medications or surgical procedures including skin debridement’s or amputation once the infection is too far

According to Healthy People 2012 there are more then 800,000 new cases of diabetes each year, with the numbers on the rise. With this in mind, Healthy People 2012 has identified diabetes as their number five focus area. In order to reach their goal of improving the quality of life for people with diabetes they have identified diabetes teaching as their number one objective. Furthermore, in order to reduce the number of complications of diabetes, Healthy People 2012 has identified foot ulcers as their ninth objective. Through patient education Healthy People 2012 hopes to reduce the number of foot ulcers in people with diabetes, as diabetes is the number one cause of nontraumatic amputations in the United States. In order to

Diabetic neuropathy is the most common factor in almost 90% of diabetic foot ulcers [9, 10]. Nerve damage in diabetes affects the motor, sensory, and autonomic fibers. In patients with peripheral diabetic neuropathy, loss of sensation in the feet can cause further damage such as repetitive minor injuries that are undetected at the time and may subsequently prompt foot ulceration. In addition, structural deformities and abnormalities of the foot further increase the risk of ulceration. Other risk factors include a previous history of foot ulceration or amputation, visual impairment, diabetic nephropathy, poor glycemic control, and cigarette smoking. This may increases the chance of infection to the ulcer. Lack of wound healing, systemic sepsis,

This can be superficial and remain in the soft tissues or it can be deep and get to the bones. Amputation is the only remedy at that stage. Studies have demonstrated that the factors causing diabetic foot infection are aerobic Gram positive cocci especially Staphylococcus aureus, methillin resistant strain (MRSA), and some streptococcus species (Warren and Lipsky, 2010). Treatments directed towards those pathogens are more likely to be successful than broad spectrum antibiotic treatments. However, Staphylococcus aureus and MRSA make diabetic foot infection treatment more difficult because they display a resistance to the

Small arteries in diabetic patients experience changes due to increased atherosclerosis. Tissue perfusion depends upon fasting plasma glucose and fasting insulin levels which are also dependent upon how sensitive the patient is to the insulin. Increased permeability to large molecules such as albumin is increased in diabetes, which can be associated with hyperglycemia (Levy, et al., 2008). Studies have shown patients with type 2 diabetes experience decreased coronary flow which is related to hemoglobin A1C and fasting plasma glucose levels (Marketou, et al., 2008). Mild insulin resistance can also be associated with a decrease in coronary flow. In addition, a decrease in myocardial perfusion in diabetic patients is related to decreased blood flow. An impairment in peripheral circulation leads to ischemia, which is associated with pain in the lower legs called intermittent claudication, which may result in lacerations of the feet (Levy, et al., 2008). Peripheral vascular disease (PVD) can cause thrombosis of the arteries causing tissue death. Gangrene from Diabetes Mellitus (DM) can lead to amputations beginning in the toes and moving into the foot (Lemone, Burke, & Bauldoff, 2011).

What was once thought to be found only among adults has become one of the most common chronic diseases among children in the United States. Ordinarily, when diabetes strikes during childhood it is assumed to be type 1. The SEARCH for Diabetes in Youth Study began in 2000 and has provided the most comprehensive estimates of the prevalence and incidence of type 2 diabetes among youth less than 20 years of age in the US (Centers for Disease Control and Prevention, 2014). The Centers for Disease Control (CDC) reports that annually, an estimated 18,436 youth are diagnosed with type 1 diabetes, and 5,089 youth are diagnosed with type 2 among youth. In the last two decades, type 2 diabetes, has been reported among U.S. children and adolescents with increasing frequency. Disease researchers at the Centers for Disease Control and Prevention made the prediction that one in three children born in the United States in 2000 will likely develop type 2 diabetes sometime in their lifetime unless they get more exercise and improve their diets, particularly for Latino children (CDC, 2014). Without changes in diet and exercise, their odds of developing diabetes as they grow older was about 50-50.

     According to the National Institute of Diabetes and Digestive and Kidney Diseases, about 17 million Americans have diabetes and every year about 1 million more age 20 or older are diagnosed with the disorder. People who are overweight, do not exercise, and are 30 years or older are more likely to get the disease (especially type 2 diabetes). People who are also of African American, Latino/Hispanic, Native American, Alaskan

This paper will explore the impact that education has on one’s lifestyle with regard to the potential of being predisposed to diabetic foot ulcer. Even though the diabetic foot ulcer usually develop after many years of having a diagnoses of diabetes, it is usually the consequences of one’s earlier actions that predisposes one to the complications of diabetes, specifically the diabetic foot ulcer.