DIABETIC ULCER

Course overview

DIABETES MELLITUS IS A METABOLIC ENDOCRINE DISORDER DUE TO AN OVERALL DEFICIENCY OF INSULIN (TYPE 1) OR DEFECTIVE INSULIN FUNCTION (TYPE 2) WHICH CAUSES HYPERGLYCEMIA. TYPE 1 DIABETES WHICH IS USUALLY SEEN IN YOUNGER PATIENTS ACCOUNTS FOR 5% TO 10% OF CASES WORLDWIDE AND IS SECONDARY TO AUTOIMMUNE DESTRUCTION OF B-ISLET CELLS OF THE PANCREAS. TYPE 2 DIABETES ACCOUNTS FOR 90% TO 95% OF CASES WORLDWIDE AND IS DUE TO GENETIC AND ENVIRONMENTAL FACTORS WITH RESULTANT INSULIN RESISTANCE AND PANCREATIC BETA-CELL DYSFUNCTION. COMPLICATIONS ARISING FROM HYPERGLYCEMIA CAN EITHER BE MACROVASCULAR OR MICROVASCULAR. THE MACROVASCULAR DISEASE AFFECTS MAINLY THE CARDIOVASCULAR AND CEREBROVASCULAR SYSTEMS, AND THE MICROVASCULAR DISEASE INCLUDES NEPHROPATHY, RETINOPATHY, AND NEUROPATHIES. A DEBILITATING COMPLICATION OF DIABETES MELLITUS IS DIABETIC ULCERS, WHICH LEADS TO INCREASED OVERALL MORBIDITY IN PATIENTS. THIS COMPLICATION MAY BE PREVENTED, AS THE INCITING FACTOR IS MOST OFTEN MINOR TRAUMA. EARLY IDENTIFICATION OF THESE CUTANEOUS INJURIES ALSO CAN LEAD TO IMPROVED OUTCOMES WHILE DECREASING THE RISK OF PROGRESSION. PATIENTS WITH DIABETES MELLITUS (TYPE 1 OR 2) HAVE A TOTAL LIFETIME RISK OF A DIABETIC FOOT ULCER COMPLICATION AS HIGH AS 25%. THIS ACTIVITY REVIEWS THE EVALUATION AND MANAGEMENT OF DIABETIC ULCERS AND THE ROLE OF INTERPROFESSIONAL TEAM MEMBERS IN COLLABORATING TO PROVIDE WELL-COORDINATED CARE AND ENHANCE PATIENT OUTCOMES.