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Diabetes and Wounds: A Dangerous Combination
By Daniel Casciato

If you or a loved one are living with diabetes, caring for wounds can be difficult. While most wounds heal without any special treatment, people with diabetes are at a greater risk for complications, such as infections. If not taken care of immediately and properly, these infections could ultimately lead to an amputation.

In fact, the rate of amputation for people with diabetes is now 10 times higher than for those who do not have this disease. One in five people who have diabetes will have an amputation, according to Dr. Christopher Hajnosz, a Pittsburgh podiatrist at South Hills Foot & Ankle Associates who also works with Ohio Valley Hospital's Wound Care Center.

The good news, he says, is that with proper foot care and wound treatment, you can easily prevent these wounds from getting worse.

"To treat any wound, the first thing we do is determine why the patient has it," says Dr. Hajnosz. "The same wound on ten different patients will have different modalities. We need to figure out what are the main causes and correct them medically and surgically, and then treat the wounds themselves."

Because people with diabetes have neuropathy—numbness in their hands or feet—they do not notice a wound to their feet right away. In addition, their elevated blood sugar affects the immune system. So it's the perfect storm, notes Dr. Hajnosz.

"You have a numb foot and poor blood flow," he says. "A patient gets a wound and their body's immune system is suppressed so the bacteria remains in the wound if not treated. This causes a full blown infection like an abscess or it can actually get into the bone."

He explains that if you cut your foot, even if it doesn't heal right away, as long as it's treated, your foot is unlikely to get infected because your body has a good immune system. For someone with diabetes, their immune system cannot fight that bacterial infection and so it can spread very quickly.

"We want to make sure your wound doesn't get worse and cause further complications," Dr. Hajnosz says. "It's not a small issue. We need to treat it and get it taken care of immediately. It may seem like a small issue to you, but we know the numbers and outcomes and it's a big issue to us. Once you have a bone infection especially in the foot or the lower extremity, there's not a lot you can do to prevent complications."

Dr. Hajnosz says that the best way to prevent wounds from getting worse is to simply take better care of your feet.

"The key to treat the wound initially is to notice it and then see a medical professional if necessary—it doesn't always have to be a wound specialist," he says. "Oftentimes, these wounds are small and in a place where you can't see it, like the back of your ankle or foot. By the time we see a patient for wound care, it's usually after a wound that hasn't healed in a normal period of time. Inspect your feet every day. Wear shoes around your house and let someone else look at your feet."

For more information, visit http://ohiovalleyhospital.org/services/wound-care-center.

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