Diabetic Feet Pose High Risks
Diabetes Patients 56 Times More Likely to Require Hospitalization for Foot Infections
WebMD News Archive
June 2, 2006 -- People with diabetes have good reason to pay close attention
to their feet.
Diabetes patients with foot wounds -- especially deep or long-lasting wounds
-- and circulatory problems are at much higher risk to require hospitalization
and even amputation.
So says a study in June’s issue of Diabetes Care. The study comes
from Lawrence Lavery, DPM, MPH, and colleagues. Lavery is a professor in the
surgery department of Texas A&M University. He also works at Scott and
White Hospital in Georgetown, Texas.
Lavery’s study included 1,666 diabetes patients who had their feet screened
and were taught about diabetes and foot care.
Patients who developed foot infections were nearly 56 times more likely to
require hospitalization and more than 154 times as likely to have a foot
amputated, compared with those without foot infections, the study shows.
Focusing on Feet
“Foot wounds are now the most common diabetes-related cause of
hospitalization and a frequent precursor to amputation,” write Lavery and
colleagues. They add that people with diabetes are 30 times more likely to have
a leg or foot amputated than those without diabetes.
Why are foot problems more troublesome with diabetes? It has to do with
diabetes’ effect on nerves and feeling in the feet.
For example, anyone can get a scrape or blister on their foot. Someone with
diabetes who has impaired sensation in the feet might not notice that wound as
soon as someone without diabetes. If foot problems fester, infection can set in
and eventually cause more serious problems that may require amputation.
Participants in Lavery’s study were enrolled in a program that focused on
preventing and treating foot complications in diabetes patients. They had their
feet carefully checked by a podiatrist and nurse, and they were taught about
diabetes and foot care.
Over the next two years or so, 151 patients -- about 9% of the entire group
-- developed 199 foot infections. Thirty-five of them had more than one foot
infection during the study.
Wounds Open the Door to Infection
Foot wounds were, by far, the most common risk factor for foot infections.
All but one of the foot infections seen in Lavery’s study were tied to foot
Wounds literally leave the body open to infection. Foot wounds seen in
Lavery’s study included burns, punctures, cuts, trauma, and even ingrown
Some wounds were more troublesome than others, in terms of infection. Wounds
that lasted more than 30 days and cut down to the bone were particularly likely
to become infected, the study shows.
Patients with poor blood circulation in their legs (peripheral vascular
disease) were also more likely to have foot infections. Circulatory problems
might make it harder to clear up infections or injuries, the researchers