Thesis Statement For Diabetic Foot Ulcer

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

I was just two weeks into my internal medicine rotation at Suez Canal University in Egypt, when I encountered a case that I still remember to this day. Ms. Rafat was an elderly diabetic patient that came into our clinic complaining of a persistent wound on the sole of her foot. Upon removing her boots, her complaint turned out to be a foot ulcer with an infection extending to the first and second metatarsal bones .Unfortunately for her, we had to break the news to her and her family that her foot would need amputation. Ms. Rafat was understandably upset but took the news in stride. Following up on her case, I learned that after the surgery, the blood flow to her leg became increasingly poor and she had to return to have a below the knee amputation. Ms. Rafat ended up dying of pulmonary embolism as a complication of her second surgery. This case stayed with me not only because it

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.

They include: heart and blood vessels, eyes, kidneys, nerves, gums and teeth. In regards to the heart and blood vessels, there are approximately 65% of death that is caused by diabetes due to major complication of heart disease and stroke. In the peripheral artery diseases diabetes also plays a major role in the cause of poor blood flow in the legs and feet. Many studies show that controlling diabetes can prevent or stop the progression of heart and blood vessel disease. Blood vessel damage or nerve damage may also lead to foot problems that can lead to amputations. More than 60% of leg and foot amputations not related to an injury are due to diabetes. Another complication of diabetes is the leading cause of blindness in the U.S. There has been a number of eye problems that if not addressed can lead to eye blindness which include: glaucoma,cataracts and diabetic retinopathy. Ninety percent of diabetic-related blindness as study shown could be prevented if there would be regular eye exams and timely treatment of diabetes-related eye problems. Furthermore, kidney failure is also one leading cause of further complication that resulted from uncontrolled diabetes in the U.S. It is said that drugs that help lower blood pressure can help the chance to developing kidney failure by 33%. Also diabetes on nerves can lead to loss of sensation or pain and burning of the feet because nerves are harmed due to over time high blood sugar levels. It can also

Those who are diabetic may also be in risk of blindness (diabetic retinopathy) and nerve damage (diabetic neuropathy). Diabetic neuropathy can lead to numbness in hands and feet, foot ulcers, and eventual limb amputation (World Health Organization). Taking preventive steps can help to avoid many of the complications of diabetes.

Diabetic neuropathy can occur with long-term diabetes, usually after several years of uncontrolled high blood glucose. Glucose proteins, called glycoproteins, form in the nerves primarily those in the legs and feet. When the nerves in the feet are damaged, the brain cannot recognize pain in that area. Nerve damage from diabetic neuropathy can lead to weakness in the muscles in the legs and feet. Since the muscles work as a system, neuropathy can lead to other foot problems, such as hammertoes, calluses, bunions, and other foot deformities. These deformities are dangerous because of the risk of infection. A simple blister from a tight shoe can spell disaster

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

Vascular diseases that prevent blood flow to the small vessels are common in people with diabetes. This condition can affect the feet in particular, so you should make regular visits to a podiatrist. People with diabetes also have a reduced ability to heal even minor blisters and cuts. A podiatrist can monitor your feet for any serious infections that could lead to gangrene and amputation.

The early diagnosis of neuropathy is crucial to stop progression to advanced stages, and further complications. (Toopchizadeh V., et al.2016) Early intervention can protect diabetic patients from a risk of foot ulcers and amputation, improve the quality of life (Vlckova-Moravcova E, et al 2008.Van Schie CH. 2008, Ismail K, et al 2007) and mitigate the socioeconomic consequences of diabetic foot disease. (Davis WA,et al 2006,Lavery LA,et al 2007,Gordois A,et al 2003 )

Uncontrolled blood sugar levels irritate the skin tissue causing it to break down and exposing the layer underneath (Kim, 2016). The most common sites are on your big toes and balls of your feet, and they can affect your feet down to the bones. According to Steven Kim (2016), diabetic ulcers are commonly caused by poor circulation, high blood sugar (hyperglycemia), and nerve damage. Poor blood circulation would not allow adequate blood flow to the feet, therefore making it difficult for ulcer to heal. Hyperglycemia can decrease the wound healing process of a diabetic foot ulcer, so blood glucose management is critical for all diabetic patients (Kim, 2016). Nerve damage/ peripheral neuropathy can result in loss of sensation in the feet due to repetitive stress. Damaged nerves can feel tingly and painful at first, but eventually results in loss of sensation which can lead to painless wounds that can cause ulcers (Kim, 2016). Thus, when patients come in with diabetic foot ulcers it is beneficial to know the cause, so the health care team can determine the course of

Diabetic foot problems are extremely common. It is the leading cause of non-traumatic amputation in America. Diabetes affects the circulation and the nerve endings in the feet. Blood flow is limited if vessels supplying blood to the feet are damaged. If they become completely blocked, this can lead to gangrene where the tissue dies from a lack of blood flow. With damaged nerves, an person may experience numbness, tingling, or burning in their feet. If permanent damage happens, all sensation could be lost. This increases the risk for

This pathology is triggered by an infection in the bones caused either by another infection in the body that travels through the bloodstream, an infected tissue near a bone, or an open wound that exposes the bone to germs (Mayo Clinic, 2015). Children are more vulnerable to infections in the long bones of the upper and lower extremities while adults are more prone to osteomyelitis in the vertebrae of the spine (Mayo Clinic, 2015). Some of the symptoms that this disease presents are fever and pain, swelling, redness, and warmth around the infection (Mayo Clinic, 2015). People with diabetes, as is the patient of this case study, can develop osteomyelitis in the feet when they develop regional diabetic ulcers, as their blood circulation is deficient and not enough white cells reach the affected area to fight the infection (Mayo Clinic, 2015). Severe cases of infection could result in amputation of the affected area to prevent the spread of the disease to the rest of the body. Patients with partial foot amputation might benefit with the use of toe filler in their shoes that replace the portion of the foot that was removed providing the patient the ability to walk normally again, like in the case of the patient mentioned earlier (Amputee Coalition, 2010). Some other complications related to osteomyelitis can include osteonecrosis, septic arthritis, impaired growth in children, and skin cancer (Mayo Clinic, 2015). Doctors use various sources to diagnose osteomyelitis, including blood tests to determine if the body is fighting an infection, imaging tests such as x-ray tests, CT, or MRI, and bone biopsies (Mayo Clinic, 2015). After the diagnosis of this pathology, the most common treatment consists in surgically removing the damaged part of the bone, followed by a course of potent antibiotics (Mayo Clinic, 2015). The best way to prevent osteomyelitis is to avoid infections, especially those related to

Joseph MacAdie (names have been changed to protect patient confidentiality) is an 87 year old gentleman who first presented in Accident and Emergency following a review from the community occupational therapist and district nurse as he was complaining of a painful left knee and decreased mobility. During the assessment the district nurse checked Mr MacAdie’s blood glucose as he had a known history of type 2 diabetes and his blood glucose was found to be 22.0 mmol/l. Due to this elevated blood glucose Mr MacAdie was advised to attend A&E. It was during this admission that following assessment Mr MacAdie was found to have an infected left great toe paronychia with left foot swelling and erythema. An X-ray of the foot was taken, which showed potential osteomylitis, and it was planned for this to be reviewed in the Endocrine department radiology meeting.

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

Diabetes is a major problem in our society today. Many people have heard about the disease; however, they do not know too much about its complications. Diabetes is a chronic, progressive and lifelong condition that affects the body’s ability to use the energy found in food (WebMD, 2016). Many new cases are confirmed every year and unfortunately, many go undiagnosed for years. Diabetes is a serious disease and need to be taking seriously. The disease can lead to many other health problems such as blindness, nerve damage and kidney diseases. The more the community understand and made aware of the seriousness of the disease, the better it can be control and or prevented.