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Burns in Patients With Diabetes

Diabetes mellitus (DM) is a disease with an increasing incidence worldwide including the US. It is expected to reach 15/1000 in the United States by the year 2050. Most burns in patients with diabetes are due to contact with hot objects or scalds. Patients with diabetes especially if uncontrolled are usually associated with poorer prognosis with more complicated and longer hospital stay compared to healthy people and need special attention as they will form a large percent of burn center and hospital admission in the future.

Diabetes mellitus is a chronic disease that has many complications, among which is the effect of diabetes on the blood vessels leading to damage, narrowing and/or blockage of the blood vessels, leading to peripheral vascular disease (PVD) that results in the alteration of blood perfusion and subsequent reduction in the oxygen and nutritional delivery to the tissues which will affect wound healing.

Diabetes can also affect the nerves leading to nerve damage (diabetic peripheral neuropathy); nerves affected by the disease are usually responsible for temperature, pressure, texture and pain sensation. The nerves of the lower legs and feet when affected can lead to insensitivity to temperature and pain in the legs and feet and patients may experience numbness and tingling sensation in these areas.

Diabetic patients with neuropathy have an increased risk of burn injuries. These burns may happen from soaking the feet in hot water, heating pads, walking on hot surface, and contact with a warming device such as heaters. Because of the impaired sensation of the feet in these patients, they may sustain a burn injury without being aware of it. These patients have poor wound healing due to the effect of diabetes on the nerves and blood vessels and the increased risk of wound infection in diabetic patients.

Burns in diabetic patients even when they are minor may lead to ulceration of the wound, serious infection and even amputation of the limb. Therefore preventing and early recognition of burns in diabetic patients is very important.

Prevention:

  1. Maintain a proper glucose level.
  2. Test water temperature before going into the bath with a sensitive body part such as the elbow.
  3. Avoid using a contact warming device such as a heater.
  4. Inspect your feet and toes every day for infection, burns, bruises and ulcer.
  5. Avoid walking barefoot even inside the house.
  6. Avoid using heating pads.
  7. Don’t wear tight or loose shoes; wear a well fit shoe with a soft, thick socks.
  8. Contact your doctor if there is an infection, an ulcer or a burn which is not healing well.
  9. Make sure your feet are examined during each doctor’s visit.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

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