Diabetic Foot Ulcers: A Cancer in Disguise

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. 

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