Diabetes Management

By Cathy L. Harmon, DNP, MSN, FNP-BC, CWON, CFCN

The impact of diabetic foot wounds is extensive. Diabetic foot ulcers (DFUs) are a major concern among those with diabetes. Research estimates that 25% of adults with diabetes may suffer a DFU sometime in their lifetime, with 20% of those requiring amputation.¹ It is also estimated that DFUs cost around $1.4 billion for inpatient care alone.¹

By WoundSource Editors

Diabetic foot ulcers (DFUs) are open sores or wounds caused by a combination of factors that include neuropathy (lack of sensation), poor circulation, foot deformities, friction or pressure, trauma, and duration of diabetes with complication risks. DFUs occur in 34% of people with diabetes, and approximately 14% to 24 % of patients with diabetes who develop a DFU will require an amputation.

Patients who are immunocompromised present a unique and difficult challenge when considering wound care and healing. These patients may include children, older adults, organ transplant recipients, patients with cancer, those with diabetes mellitus, or those with HIV/AIDS. Immunocompromised patients are at increased risk of hypothermia, infection, and otherwise poorly healing or recurrent wounds. Many treatments for infection and interventions to promote wound healing rely on a properly functioning immune system. In immunocompromised patients, alternate treatment methods are needed to compensate for the impairments in their natural immune response.

For the past two decades, I've had a deep interest in wound care, but my son's wound care experience in 2020 shifted my attention to a largely overlooked population. As a mother, as I prepare to face his third incarceration, I am an even stronger advocate for transforming families and the lives of those who have been incarcerated. I have recently become a Prison Fellowship Justice Ambassador. In my perspective, we must never lose sight of the fact that the prison population is a subset of the general population.

Diabetic foot ulcers (DFUs) may affect up to 25% of people with diabetes at some point in their lifetime. Once a person has developed a DFU, there is a 50% chance the ulcer will become infected. DFUs are also among the leading causes of amputation.

By Alton Johnson Jr., DPM, CWSP

Since my last blog post, I was fortunate enough to turn 32 years old. To many of us, turning 32 years old does not seem like much of a big deal, but as an African American man, it is, because the average life expectancy of a Black man in America is 75 years, which is the lowest life expectancy of all ethnicities in America. Essentially, in five years, I will be statistically at my midlife. It is with that mind that I work tirelessly for all patients, but I try to emphasize to African American patients the importance of wound healing, diabetes management, and overall healthy well-being.

Holly Hovan MSN, RN-BC, APRN, CWOCN-AP

Diabetes is extremely prevalent in the United States. The Centers for Disease Control and Prevention (CDC) report that over 10% of the US population has this chronic disease, and 26.8% of older adults (65 and over) are impacted by diabetes, both diagnosed and undiagnosed.

By the WoundSource Editors

Diabetic foot ulcer (DFU) complications are challenging and costly. Evidence-based practice and advanced wound care technologies have the potential to maximize good outcomes and prevent ulcer recurrence, but ensuring that patients receive education on diabetes management and DFU prevention is also a vital step. Over time, people with unmanaged diabetes have increased chances of complications such as neuropathy, peripheral vascular disease (PVD), chronic DFUs, infections, osteomyelitis, amputation, and even death.

By the WoundSource Editors

Advanced wound care technologies have come a long way in treating chronic wounds. However, diabetic foot ulcers (DFUs) can be challenging, and not every patient should have identical treatment. Utilizing a patient-centered approach is necessary for selecting appropriate treatments and achieving best possible outcomes. Understanding the specific patient’s needs and understanding the pathophysiology of diabetic wound chronicity are key elements in DFU management. The primary goal should be wound closure, while also preventing recurrence. To achieve both goals, clinicians must incorporate ongoing education and clinical support. Health care professionals should keep up on latest evidence-based research and practices to select the best advanced treatment for each patient.

By the WoundSource Editors

Diabetic foot ulcers (DFUs) continue to be a major problem, causing patient suffering, burden, infections, and high mortality. The cost of DFU treatment was estimated at $1.3 trillion globally in 2015. Despite evolving advanced wound care technologies through the years, DFUs continue to be among the most challenging chronic wound types.