Foot ulcers: Research identifies factors key to healing diabetes-related foot sores

Diabetes is becoming more and more common. Today some 5-10 percent of the population is estimated to suffer from the disease. One common complication is foot ulcers, which affect 12,000 diabetics in Sweden each year. This is a group that requires a great deal of highly specialized care in hospitals to avoid amputation.

"People who have had diabetes for a long time often develop poor blood circulation in their legs, which hampers healing," says Magdalena Annersten Gershater, a registered nurse and researcher at Malmö University.

Gershater is surprised that so many patients have poor blood circulation.

"Our study also shows that age as such is not a risk factor," she says.

In some cases the foot ulcer is so complicated that it's necessary to amputate. Gershater has performed a study to find out what factors are related to whether patients with diabetes and foot ulcers heal with or without amputation. The study, with 2,480 patients, is the largest of its kind.

"The study shows that 65 percent of the patients healed without amputation. What was decisive for the ulcer to heal was that the sore is superficial, that the patient has not had diabetes for long, and that blood circulation is normal," says Gershater.

Nine percent were resolved with amputation of toes or the front of the foot, while eight percent underwent leg amputation.

"The study shows that deep infections, vascular disease, the location of the sore, male gender, and other disease all increase the risk of amputation."

On October 28, Gershater will publicly defend her dissertation Prevention of foot ulcers in patients with diabetes mellitus. The dissertation also contains studies on healthcare in the home and how nurses in this field work preventively in regard to diabetes and foot ulcers.

"Diabetes care in home care can be improved considerably. The fact that it does not function satisfactorily is partly an organizational problem," she says.

Gershater now hopes that her findings will be applied to the treatment of patients with diabetes and foot ulcers.

"Many of these patients have multiple diseases and need a great deal of care. This means that you have to have a holistic view of the patient in order to do a good job as a diabetes nurse."