Diabetic Foot Infections

Excerpt

There are approximately 29 million people with diabetes in the United States, and approximately 25% of people older the age of 65 have diabetes. The incidence of diabetes worldwide is projected to increase by 55% over the next 20 years, so this problem is only going to get worse. Approximately 75% of diabetic neuropathies is distal symmetric polyneuropathy (DSP). Once peripheral neuropathy develops the annual incidence of ulcer formation increases from less than one percent to greater than 7%. The three-year mortality for people with diabetes increases from 13% to 28% with an ulcer.

The other major factor in diabetic foot infections is the compromised blood flow. In the presence of local trauma and microvascular disease, diabetic foot infections may vary from a simple case of cellulitis to full-blown gangrene.

Osteomyelitis occurs in 15% of ulcers, and 15% of those will go on to require amputation. In fact, approximately 60% of patients undergoing lower extremity amputation have diabetic foot ulcers as the underlying cause. Following a lower extremity amputation, the five-year mortality jumps to 60%. Diabetic foot ulcers are precursors to amputation and mortality, and therefore, every effort should be made to prevent them.

Treating diabetic foot infections is not easy as the blood flow is compromised and the antibiotics usually cannot reach the diseased area. In many patients with diabetes mellitus, a foot infection progresses and the cure can take a lot longer compared to a nondiabetic.