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"Can diabetic foot ulcers cause premature death?"
I just read an article that said that people with diabetes who have foot ulcers are at an increased risk for premature death, heart attacks, and stroke. I am a diabetic and I have severe ulcers on the bottom and sides of my feet that will not heal. I know I have poor circulation in my feet and legs, and I also have peripheral neuropathy and sometimes cannot feel when my foot is infected. My doctor told me that my foot may have to be amputated. Now, in addition to worrying about losing my foot, and I going to have to worry about dying sooner than I should if I can't get my foot ulcers to heal?
It is true that diabetic foot ulcers are associated with severe medical problems such as heart attacks and strokes, which is why you must be managed by a team of physicians. However, there is not any direct link between the foot ulcer itself and these other diseases. The reason that diabetic foot ulcers are predictive of things like heart attacks is because ulcers are a sign that the vascular system is not healthy. The excess sugar that circulates in the bloodstream of diabetics will eventually damage the blood vessels throughout the body. This kind of damage occurs in people who have had diabetes for a long time or in people whose diabetes is poorly controlled. Smoking makes the damage to blood vessels immensely worse. Chronic, non-healing leg and foot ulcers develop when enough damage has been done to the blood vessels that not enough blood can circulate to the legs for healing to take place. When the blood vessels are damaged this badly in the legs, they are almost always damaged in other parts of the body like the heart and brain. The result of damaged blood vessels in the heart is increased risk of having a heart attack and the result of damaged blood vessels in the brain is an increased risk of having a stroke. If you have ulcer disease in your lower extremities that is severe enough that amputation is being considered, you are definitely at increased risk for heart attacks and strokes. The first thing you can do to reduce your risk for these health problems is to make sure your diabetes is very well managed. See your primary care doctor or endocrinologist regularly and follow all the advice that they give you. If you are a smoker, the second thing you can do to improve your health is to quit smoking immediately. A diabetic with severe vascular disease needs a team of physicians managing their health. You need a primary care physician who will direct your care. You need to see an endocrinologist who can manage your diabetes and its complications. A cardiologist can assess your heart health and perform special testing to determine the condition of the blood vessels feeding your heart. Finally, if you have severe ulcer disease in your lower extremities, you need to see a vascular surgeon to determine if a revascularization procedure or an amputation will be required (and your vascular surgeon will require you to be evaluated by a cardiologist before surgery would be considered).
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