Diabetes is a chronic health condition that lasts a lifetime and often results in secondary health problems. From Type 1 to Type 2 diabetes, it’s essential to be aware of the health risks you are pre-disposed to with a diabetes diagnosis. Burn and Reconstructive Centers of America (BRCA) is dedicated to shedding light on this potentially detrimental but manageable metabolic disorder during National Diabetes Awareness Month and all year around.
According to the CDC, 11.3% of the total U.S. population suffers from diabetes—that’s about 37.3 million and growing every year. When managed properly, secondary issues because of diabetes can be limited. However, when allowed to get out of control, diabetes can lead to severe and life-threatening complications such as diabetic shock, bone infection (osteomyelitis) and limb amputation. For Type 2 Diabetic Jill Bird, a digit and appendage amputation was just narrowly avoided after suffering a side effect of diabetes known as diabetic neuropathy.
“I was working for a food distribution company where I basically run a food line,” Bird said. “So, I’m on my feet for the full 12-hour shift. I was on my fourth day of 12-hour shifts and didn’t realize how bad my neuropathy was until I got home and took my sock off and had a great, big, huge blister. And I was like this is not good.”
Diabetic neuropathy is a degenerative nerve condition that creates a progressive loss of feeling in the feet. Per BRCA podiatric and wound specialist Dr. Tony Quinton as a gradual loss of the body’s protective pain threshold, neuropathy can prevent those who have diabetes from feeling damage to their feet or other peripheral body parts, allowing wounds to go unnoticed for extended periods. While Bird noticed the blister after that shift on December 28, 2021, that does not mean it hadn’t formed much earlier, promoting bacterial colonization.
As Bird would find out in the shower later that night, the bacterial colonization of the wound had progressed into something more troubling. From the foul smell, there was no question that the diabetic ulcer that had formed on her foot was infected and needed to be treated immediately. The following morning, Bird made an appointment with her primary care physician, hoping they would know what to do about her infected wound.
“And my doctor says, ‘Oh no, I need to send you somewhere that specializes in wound care,’” Bird said. “The wound was already pretty bad, and he didn’t want to do anything that might make the wound worse.”
She was referred to Dr. Quinton at BRCA Idaho for specialized treatment of her diabetic foot ulcer. When she arrived for a consultation, Dr. Quinton discovered that treating the infection would require much more than a round of antibiotics.
“Jill had a diabetic foot ulcer with a bone infection called osteomyelitis,” Dr. Quinton said. “It’s much more difficult to treat without surgery. Unlike an infection in your skin or muscles that medicine can usually kill, a bone infection can be difficult to treat without more aggressive surgical intervention, such as amputation.”
The bone infection was progressing rapidly, and there was a fifty percent chance that Bird would lose some or all of her foot if her medical team couldn’t get the infection under control. In hopes of avoiding amputation, Dr. Quinton took the conservative path and, instead of beginning with aggressive surgical intervention where Bird was at risk of losing her big toe, began her treatment in the hyperbaric chamber.
Hyperbaric oxygen (HBO) therapy is a non-invasive medical treatment involving breathing 100% oxygen in a pressurized chamber. This treatment method promotes oxygen absorption into the lungs and bloodstream, stimulating the release of stem cells and growth factors that aid the body’s healing and immune processes. Or, as Dr. Quinton put it, HBO therapy supercharges a person’s blood with oxygen, so they can have a better chance of fighting off infection. In total, Bird underwent around 80 “dives” in the HBO chamber between December and April.
“In foot wounds, there are only really three reasons we can use hyperbarics, and that’s one of them—chronic wound with a bone infection,” Quinton said. “There is some evidence that it helps as long as you’re doing it alongside all the other things—proper IV medication, good wound care, staying off your foot. All those things combined can help a lot.”
By the end of April, Bird’s infection was under control, and her foot was no longer at risk of amputation. However, she is still working on managing her diabetes, which is always a work in progress, especially with the rising cost of insulin products.
“Seriously, just from going through this experience, I see how diabetic people just give up,” Bird said. “I’ve just seen the horrible things that can happen, and nothing in this world is worth jeopardizing your health.”
Since her recovery, Bird has changed her daily routine to keep up with her body’s needs, including checking her feet daily, watching where she walks and even purchasing shoes specially designed for those who have diabetes. By sharing her experience and nearly losing her foot, Bird hopes to inspire other diabetics to take charge of their health and wellbeing.
“I truly want to help other people,” Bird said. “This has been such a life-changing, altering experience for me. You cannot jeopardize your health ever. You get one body, and that’s it.”
For Bird and others like her, there are three contributing factors to the formation of diabetic foot ulcers: neuropathy, circulatory issues and foot deformities. Everyone with diabetes has some degree of vascular disease, constricting the blood vessels, reducing circulation and causing an increased risk of chronic or non-healing wounds. The feet muscles are also significantly weaker and prone to deformities, such as hammer toes, contracted toes and higher arches. These deformities are conducive to abrasions, ulcers and other wounds when combined with neuropathy.
“Muscle weakness causes foot deformities, and the foot deformities cause increased pressure, so that combined with neuropathy and bad blood flow are generally the underlying cause of diabetic foot ulcers,” Quinton said.
It’s crucial for those suffering from these secondary conditions or diabetic wounds not to wait to seek treatment. As Dr. Quinton told Bird, many who wait to seek treatment and try to treat their wounds at home usually end up with more severe wounds and deeper infections that won’t respond as well to HBO therapy or IV antibiotics, resulting in amputations. If you are struggling with managing your diabetes or want to know more about reducing the risks of diabetic ulcers and chronic wounds, find a wound specialist that is right for you and follow up with them regularly.
“I have never had a doctor this on point, like as far as patient care,” Bird said. “Dr. Quinton knew exactly what to do and how to treat it. He has me as a patient for life.”
Diabetic ulcers occur in approximately 15% of diabetic patients. If treated properly, patients can avoid amputation, which affects about 1 in 5 patients who develop an ulcer.
Diabetic ulcers are most commonly found on the feet, but they can develop on the legs, hands or in folds of skin on the stomach. Ulcers are open sores (wounds) on the skin that haven’t healed properly. Diabetes raises the odds of getting an ulcer due to high blood sugar, which can, over time, cause damage to nerves and blood vessels, lessening blood flow and making it more difficult for sores and cuts to heal.
For more information about our diabetic wound services, please click here. If you are suffering from a stubborn or unhealing wound, please don’t wait to seek help. Call our experts 24/7 at (855) 863-9595 for your non-emergent needs. For emergencies, please call 911.
For a Q&A about the risk of diabetic wounds with our wound experts, please click here.