Diabetic foot ulcer information

Diabetic foot ulcers are chronic wounds that are the result of repetitive trauma in the insensate foot. The presence of infection and peripheral vascular disease makes the treatment of these wounds difficult.

Diabetic foot ulcer treatment
The main principles of the management include good wound care, such as aggressive debridement of all non-viable tissue, adequate off-loading of pressure, prompt treatment of infection and moist wound dressings. Over the last decade, new therapeutic modalities, including growth factors and living skin equivalents, have been available to the practicing physicians. Judicious use of advanced wound care products may provide the best means of treating these challenging wounds in an efficient and cost-effective way. It is important to maintain low blood sugar levels in the patient with diabetes in order to keep immune function of the host at its best.

Digital thermometer to prevent diabetic foot ulcer
Adding a daily check of foot temperature with an infrared skin thermometer to standard diabetic foot therapy can significantly reduce the recurrence of diabetic foot ulcer. The digital infrared thermometer, called TempTouch, costs approximately $150 and is powered by 9-V batteries. Elevated skin temperature is a sign of inflammation and tissue injury, but the signs may be too subtle to detect. Diabetes Care, January 2007.

Mortality rates
Five-year mortality rates after new-onset diabetic ulceration have been reported between 43% and 55% and up to 74% for patients with lower-extremity amputation. These rates are higher than those for several types of cancer including prostate, breast, and colon. Cardiovascular diseases represent the major causal factor, and early preventive interventions to improve life expectancy in this most vulnerable patient group are essential. New-onset diabetic foot ulcers should be considered a marker for significantly increased mortality and should be aggressively managed locally, systemically, and psychologically.

A lifestyle disease
Diet, activity level and other lifestyle factors play a crucial role in a person's risk of developing diabetes -- even after age 65. Dr. Dariush Mozaffarian of the Harvard School of Public Health, Boston, believes diabetes is fundamentally a lifestyle disease. Dr. Dariush Mozaffarian followed 4,880 men and women, aged 65 and older, over a period of 10 years. All were free of diabetes at the beginning of the study. During follow-up, 337 people developed diabetes. A person's risk of diabetes fell by 35 percent for every low-risk lifestyle factor they had. Compared with all other study participants, the risk of diabetes was 82 percent lower for people in the low-risk groups for activity level, diet, smoking and alcohol use. Mozaffarian concludes that 9 out of 10 of the cases of diabetes that occurred among the study participants could be attributed to lifestyle factors. Archives of Internal Medicine, April 27, 2009.

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