Whether you are new to wound care, or a seasoned veteran, you’ll most likely encounter patients with diabetes on a regular basis. And by far, the most common wounds seen in these patients are diabetic foot ulcers, said Bill Richlen, PT, WCC, DWC, clinical instructor for the Wound Care Education Institute.

By Carole Jakucs, MSN, RN, PHN

According to the American Diabetes Association, diabetes has affected more than 31 million people in the U.S. since 2015.

“In addition to diabetic foot ulcers, diabetics can also get venous and pressure ulcers too,” said Richlen who also owns Infinitus LLC in Santa Claus, Ind., a wound care instruction and consulting company. “Having a diagnosis of diabetes can complicate and delay the healing process of any type of wound.”

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Patients with diabetes are more likely to suffer many serious health issues besides foot wounds and amputations. This makes it imperative that they resolve to get their blood glucose levels under control.

All of the lawsuits I review have a common theme. The plaintiff suffers from a chronic wound and some degree of malnutrition and/or dehydration. I have started to notice that in addition to these problems, the plaintiff also quite often has diabetes. This trifecta of problems leads to pain, suffering, disability, and discontent.

Nancy Collins, PhD, RDN, LD, NWCC, FAND

People with diabetes are 10 to 20 times more likely to have a lower extremity amputation than those without diabetes.¹ This is a scary statistic compounded by the fact that people with diabetes may not even notice a foot wound developing because they cannot feel it because of neuropathy. A foot ulcer is the initial event in more than 85% of major amputations that are performed on people with diabetes.² Knowing this should provide enough motivation for patients to get their diabetes under control, but some people need even more reasons. Here are eight more consequences you can discuss with your patients. Hopefully, one will hit home.

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Changes in the diabetic foot can happen fast: here are the signs and types clinicians in wound care need to look for.

As a wound care professional, chances are you’ve treated a number of nail conditions and abnormalities that occur among the general population. But when you’re working with diabetic patients, noticing and identifying variations is even more crucial. This is because change can happen more rapidly in the diabetic foot, and pathologies in diabetic toenails can ultimately lead to skin breakdown, foot ulcerations and infection. So, what causes the nails to change? What exactly should you look for? We’ve got you covered.

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Check out these best practices for trimming your diabetic patient’s toenails to help prevent foot ulceration.

Did you know that a whopping 10-25% percent of all patients with diabetes ultimately develop a foot ulcer – a diagnosis that brings a five-year mortality rate of nearly 50%? Consistent foot care, such as regular screenings, footwear assessment and nail maintenance can help prevent ulceration.

You can help diabetic patients with nail maintenance by taking extra care to preserve the integrity of the toenails. This includes keeping the cuticles and surrounding skin intact, and following best practices when trimming the nails. That’s why we’ve put together our top tips for proper trimming.

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Five clinical tests for diagnosing loss of protective sensation in the diabetic foot, plus tips on inflammation assessment.

How serious are diabetic foot ulcers? The statistics are sobering:

• It is estimated that between 10 and 25% of patients with diabetes will develop a foot ulcer in their lifetime.
• Diabetic foot ulcers precede 84% of all lower leg amputations.
• The five-year mortality of patients with newly diagnosed diabetic foot ulcers (DFUs) is nearly 50%, and carries a worse prognosis than breast cancer, prostate cancer, or Hodgkin’s lymphoma.

In addition, DFUs are at increased risk for infections and other complications, and continue to be a major cause of hospitalizations and additional healthcare expenditures.  So while patients suffer greatly from DFUs, these chronic wounds are also a huge financial burden on healthcare systems. This is because these same patients spend more days in the hospital, and experience more visits to the emergency room and outpatient physician offices than other patients with diabetes.

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When it comes to diabetic wound care, footwear matters – and proper diabetic patient shoe assessment is key.

Wound clinicians know how devastating foot amputations are for diabetic patients. But what you might not know is that a whopping 50% of diabetic foot amputations are a direct result of patients wearing improper footwear. Surprised? Unfortunately, this staggering statistic is accurate. But the good news is that there’s something we can do about it. If we get diabetic patients to wear the proper shoes, we can cut diabetic foot amputations in half.

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