Diabetes FAQ » Diabetes Q&A » I heard that diabetes could cause gangrene is this true? I thought gangrene was caused by frostbite?

I heard that diabetes could cause gangrene is this true? I thought gangrene was caused by frostbite?

Most people associated gangrene with frostbite where areas of the body that have been exposed to extremely cold conditions gets so cold the oxygen supply is cut off and gangrene sets it. When this type of gangrene occurs it is called a dry gangrene. Gangrene can also be caused by a bacterial infection and this type of gangrene is called a wet gangrene.
Diabetes left untreated over time, lead to many feet and skin problems. Diabetes is a result of too much sugar in the blood, which is known as blood sugar or blood glucose.

High blood glucose will cause two different situations that will affect your skin and feet. First of all it can cause nerve damage. Nerve damage is called neuropathy and when it happens in diabetics, it is called diabetic neuropathy.

When you have nerve damage in your legs and feet there is a possibility that you will not feel any aches or pains, but you may not feel heat or cold either. You may not notice a sore on you leg or foot because you don’t feel any pain. This untreated sore can get severely infected.

The second situation that can occur with diabetes concerning the feet and legs is poor blood flow. When you don’t have enough blood circulating in the legs and feet, the sores take even longer to heal. This condition of poor blood circulation is called peripheral vascular (PVD). Smoking can even make this situation worse.

The two conditions together create a foot or leg problem

It is quite possible to have a blister from tight fitting shoes and not even notice it visibly or feel the pain. Because of the nerve damage and poor circulation, the blister does not heal properly. This means, in this example, the two conditions work together to create the complicated that will eventually lead to gangrene if not treated quickly. In some patients who suffer from diabetes, the sore may get infected. It is the extra sugar in the blood that feeds the germs in the festered blister and they multiply. Some times the infection can get so bad that it doesn’t heal. When that happens gangrene can set in. Tests for gangrene:

• Physical examination.
• X-rays.
• Arteriogram This is a kind of x-ray to check for blood vessel blockage.
• Blood test to check white blood cell count.
• CAT Scan to check internal body organs.
• Tissue culture or fluid sample from the wound or sore to look for any bacterial infection.

Surgery to remove the dead skin from the wound

When gangrene sets in the tissue and surrounding skin around the sore will die. It will turn black and it will be smelly. In mild cases of gangrene dead tissue will be removed to prevent further spread and infection. Removing the dead tissue is called debridement.

Treatment for gangrene

Gangrene needs to be treated immediately. Gangrene can spread and when that happens the doctor has to amputate the dead area often having to cut off a foot or even a good part of the leg in order to stop the gangrene from spreading. Even with gangrene the wounds may heal but it all depends on how controlled blood sugar levels are, how much damage was done, if the infection is serious and still active, and how much good blood is flowing around the area of the wound. If these factors are not favorable then amputation is often the option.

Treatment

• Removal of dead skin from the wound site – sometimes several surgeries are necessary to promote healing.
• Antibiotics.
• Surgery to improve the blood supply to the affected area.
• Treatment in intensive units.
• Reconstruction surgery.

To prevent gangrene

• Wounds must be taken care of immediately.
• Patients should watch for redness, swelling and especially leakage.

Type 2 diabetics must see their doctors immediately before letting the wound get worse.

Diabetics with any wound such note if they have fever

Fever is a sign of a complication. Diabetics should periodically watch for wounds or changing skin color on their legs and feet to prevent serious complications.

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