Patient/caregiver were instructed on the contribution of poorly controlled atherosclerosis for development and poor healing of diabetic foot ulcers as follows:
- Atherosclerosis is increased deposition of fats and cholesterol on the inner walls of the blood vessels. Poorly controlled blood sugars in diabetic individuals also is a strong factor contributing to increased atherosclerosis.
- Excessive deposition of fats and cholesterol progressively close down the lumen of involved blood vessels and reduce blood flow through them.
- Poorly controlled blood sugars in diabetic patients over time also result in increased production of toxic inflammatory chemicals in the body.
- On chronic exposure, these toxic inflammatory chemicals, in addition to damaging the nerves, can also further damage to the small blood vessels supplying the oxygen and nutrients to the distal extremities.
- The damage to the nervous tissue can impair the ability of nerves to communicate various signals and compromise an individual’s response upon exposure to various sensations, such as, touch, pain, and temperature.
- Rich blood flow with good supply of oxygen and nutrients is needed for repair of the damaged nerve tissue. But the impaired blood circulation with poor supply of oxygen and nutrients to the distal extremities in poorly managed atherosclerotic diabetics, can make the repair difficult.
- This predisposes the individual to permanent nerve damage, risk for skin integrity, and development and/or poor healing of diabetic foot ulcers.
- Also, 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.
