Patient/caregiver were instructed on the contribution of poorly controlled hypertension for development and poor healing of diabetic foot ulcers as follows:
- Poorly controlled blood sugars in diabetic patients over time result in increased production of toxic inflammatory chemicals in the body.
- Chronic exposure of the nerve tissue to these inflammatory chemicals lead to progressive damage to the nerves and impair the ability of nerves to communicate various signals.
- This results in compromise of an individual’s response upon exposure to various sensations, such as, pain and temperature.
- For this reason, individuals with poorly controlled diabetes are often unable to detect the insult to their lower extremities and many wounds go unnoticed before they get infected and turn complicated.
- Rich blood supply delivering fair amounts of oxygen and nutrients is needed for repair of any damaged nerve tissue.
- Coexisting poorly controlled hypertension puts extra force against the walls of blood vessels, which over time can damage the vessels, plaque built-up, and consequent narrowing of the vessels.
- This can result in reduced blood flow through the involved blood vessels, thus impairing supply of much needed oxygen and nutrients to the damaged nerve tissue in repair.
- This makes the repair of nerve tissue difficult, thus predisposing 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.
