Last fall researchers from St. George's, University of London published findings in Diabetologia stating that those with diabetic foot ulcers are at a higher risk of dying prematurely than those without the condition. The study was the largest analysis of diabetes and the link between foot ulcers.
Diabetes can damage a person's blood vessels and nerves, especially when they are a poorly controlled diabetic. This in turn leads to neuropathy, when you have a diminished, or no sensation in your extremities. A person with diabetes is less likely to notice cuts, scrapes, abrasions, or injuries that can turn into ulcers and wounds.
The study included 17,830 patients with diabetes- 3,095 with foot ulceration and 14,735 without, investigating how diabetic foot ulcers affected a person's chance of dying earlier. They found that those with a history of foot ulceration had a higher death rate than those without. There were an extra 58 deaths per 1,000 people each year with foot ulceration.
The study included patient records for eight studies published between 2006 and 2011 and conducted in Europe, America, Australia, and Southeast Asia. Patients were followed from two years to 10 years.
Those with foot ulcerations showed more cardiovascular risk factors, like high blood pressure, and were more likely to die from complications. Half of the additional deaths were due to heart attack or stroke. This was not investigated in this particular study, but is an area of further research, as there is potentially a link between infections and complications of foot ulcers.
Robert Hinchliffe, of St. George's, who co-led the study, said, "Our research, which is the largest and therefore most reliable study to date, shows that people with diabetes who have foot ulcers are at considerably higher risk of an earlier death compared to those patients without. We suspect that this may be due in part to the effect of infections among those with foot ulcers and the greater co-existence of cardiovascular disease and foot ulcers with diabetes although the reasons are not entirely clear."
The researchers say this calls for a two-pronged approach for those with diabetes: enhanced foot ulceration screening, as early detection and treatment may curtail some of the complications; and more intensive control of blood pressure and cholesterol among those with foot ulcers.
The current recommendations are to control your blood sugar, wearing socks to prevent foot ulcers, self-checking for abrasions, and getting a complete foot exam at least once a year.
Professor Kausik Ray, who co-led the research, said, "Our result warrant further investigation as to whether even greater control of risk factors such as blood pressure, blood glucose, and early preventative screening can further reduce mortality among those with foot ulcers. There is likely an unmet potential to reduce deaths in this group."
If you are a diabetic and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Diabetic Foot Care in CT
Podiatrist in Bristol, CT
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