Patient/caregiver were instructed on the contribution of obesity for development and poor healing of diabetic foot ulcers as follows:
- Increased resistance to action of insulin in diabetic patients can lead to impaired glucose transport from blood into the cells, contributing to elevated and poorly controlled blood sugars.
- Over time, poorly controlled blood sugars can lead to excess deposition of visceral fat, poorly regulated body mass index (BMI), and obesity.
- Excess visceral fat in obese individuals produce increased amounts of toxic inflammatory chemicals in the body.
- Chronic exposure of the nerve tissue to these inflammatory chemicals lead to progressive damage to the nerves, impair the ability of nerves to communicate various signals, and compromise the diabetic individual’s response upon exposure to various sensations like pain and temperature changes.
- This can predispose the individual to risk for skin integrity, and development and/or poor healing of diabetic ulcers.
- Also, obese individuals can present with altered gait patterns due to other coexisting factors, such as, poor balance and pain in the weightbearing joints.
- These altered gait patterns can increase the stress on some portion of the foot, contributing to excess wear & tear and development of foot ulcers.
- Compromised pain sensitivity in the extremities of poorly controlled diabetics allows these individuals to continue ambulating around on an ulcerated area of the foot, thus exposing the site to increased risk for infection and poor healing.
- Also, obese individuals can often present with challenges performing self-care and daily foot examinations due to difficulty reaching out to lower extremities, which can complicate the outcome and impair healing of the foot ulcers.
