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Diabetes mellitus is a metabolic disorder of chronic hyperglycemia characterized by disturbance of carbohydrate, protein and fat metabolism resulting from an insulin deficiency with dysfunction in the organ system.

 In other words, Diabetes mellitus is a disease that causes high blood sugar and it occurs when there is a problem with insulin in the body; a hormone that regulates blood sugar level.

One of the most common, serious and potentially life-threatening complications of diabetes is diabetic foot ulcer. It is also a common cause of lower extremity amputation (LEA) in severe cases.

“It is estimated that persons with diabetes mellitus have a 25% chance of developing diabetic foot ulcer.”

Diabetic foot ulcers or wounds refers to a break in the continuity of the skin’s epithelium (layers). It is of great concern as it most often involves the full thickness of the skin and sometimes beyond; going deep into muscle or bone. It largely occurs in areas below the ankle joint in individuals living with diabetes mellitus.

“Foot ulcers affect 1 in 10 persons living with diabetes.”

DFU’s result from the interaction between the foot in question, repeated mini- injuries to the foot and an overall infection of the wound created. The major problem with diabetic foot ulcers is that they tend to heal slowly or may fail to heal completely and are extremely prone to infection. This results in ischemia, tissue death and finally, gangrene.

When this happens, amputation is necessary to salvage the affected limb and provide a window for future ambulation (chance to walk) without difficulty and pain using a prosthesis (artificial limb).

If I am diabetic, what predisposes me to having or developing a foot ulcer?

Majorly, poor glycemic control, advancing age, presence of neuropathy and peripheral vascular disease top the list of predisposing factors.

Peripheral Neuropathy: weakness, numbness, loss of sensation and pain from nerve damage, usually occurring in the hands and feet.

Peripheral vascular or arterial disease: a circulatory condition in which narrowed blood vessels reduce blood flow to the limbs. It is also a sign of atherosclerosis which is the presence of fatty and calcium deposit building up in the walls of blood vessels.

Peripheral neuropathy in the lower limbs predisposes diabetics to develop foot ulcers by causing a loss of the protective sensation in the foot and formation of foot deformities which impede or hinder movement, weight-bearing, callous formation and eventually lead to ulceration.

“Although DFU’s are the most common complication of diabetes, they are also the most preventable!”

Prevention is key in the management DFU all over the world and Knowledge on appropriate foot care is absolutely empirical. Here are a few tips on how to prevent diabetic foot ulcers:

  • Daily foot check or inspection for wounds no matter how little.
  • Daily foot moisturizing to combat dryness or flakiness.
  • Regular toenail cutting.
  • Wearing well-fitted footwear; not too tight and not too loose. Just perfect.
  • Blood sugar control at all times.
  • Smoking cessation.  
  • Lifestyle and diet modification/control.

Sources

Uloko A.E, Musa B.M, Ramalan M.A, Gezawa I.D, Puepet F.H, Uloko A.T, Borodo M.M, Sada K.B. Prevalence and risk factors for diabetes mellitus in Nigeria: A systematic review and meta-analysis. Diabetes therapy Journal (2018) 9:1307-1316.

Ugwu E, Adeleye O, Gezawa I, Okpe I, Enamino M, Ezeani I. Burden of diabetic foot in Nigeria: current evidence from the multi-centre evaluation of diabetic foot ulcer in Nigeria. World Journal of Diabetes 2019, March 15; 10 (3): 200-211.

Raimi T.H, Fasanmade O.A. Precipitating factors for diabetic foot ulcer in a Nigerian tertiary hospital. European Journal of biology and medical science research vol. 6, No 2, pp. 21-28, May 2018.