We recently were approached by our friend Louis who wanted to share more on diabetic foot complications with our community. We absolutely loved this idea and so asked him to write a blog post. Please see below for more!
Diabetes is no laughing matter, especially when the symptoms of the disease become advanced. Because diabetes is treatable rather than curable, treatments for advanced diabetes complications like diabetic foot tend to be very intense. Unfortunately, their role tends to be closer to damage control than to resolving the problems they address.
"Diabetic foot" is a catch-all term for the many different health problems caused by diabetes that manifest themselves on the feet. These problems can be severe and even life-threatening. The most common sort of physical damage that occurs with diabetic foot is an ulceration caused by poor healing. A more serious concern which may or may not be linked with ulcers is a potentially-fatal infection.
There are two mechanisms that expose diabetics to these serious risks. The first is peripheral neuropathy, a progressive form of nerve damage that leaves diabetics with numb feet and an inability to feel the pain signals that are common warning signs of injuries. The other issue is low blood pressure combined with poor circulation in the feet. A shortage of oxygenated blood reduces the body's ability to heal from foot injuries and makes it more susceptible to infections.
A PICC line is a long-term catheter designed to administer certain forms of medication directly to the heart. PICC stands for peripherally inserted central catheter. PICC lines are inserted in one of the arm's peripheral veins and then carefully threaded through the circulatory system until the end of the catheter rests in the superior vena cava, immediately above the heart. PICC line insertion is performed in a hospital. It requires a sterile environment, but it's not a surgical procedure. There are some great previous posts on PICC lines here, here and here.
PICC lines are only inserted when doctors prescribe potent medicines that need to be administered over extended periods of time. Despite the sensitive placement of the PICC line, it does not pose any particular danger to the patient and usually remains in place for weeks or even months. Patients being medicated via PICC line do not have to stay in the hospital; it's often left in for home treatment. At the end of the relevant prescription, a PICC line can be removed (in a hospital or at home) by a qualified nurse or physician's assistant.
While PICC lines are used to deliver a wide range of different medicines, in cases of diabetic foot they're usually used for two specific classes of medication: antibiotics and vasopressors. Antibiotics fight the infections that are common in diabetic foot patients. Vasopressors raise blood pressure and encourage increased blood flow.
Antibiotic treatment for diabetic foot is often extremely aggressive, featuring high doses of fairly exotic antibiotics administered over long periods, usually several weeks. This is required due to the reduced healing abilities of severe diabetics. Patients with advanced cases of diabetic foot are also at risk for infection by antibiotic-resistant strains of bacteria; this is another factor calling for lengthy and intense antibiotic treatment.
The insertion of a PICC line, no matter how safe and routine it is, is definitely not a good sign. When it's used to treat diabetic foot, a PICC line can be taken as a sign that the patient is in a severely risky condition. Aggressive treatment is required to stabilize the patient's condition and prevent further damage; at this point in a case of diabetic foot, amputation is a very real possibility.
Sadly, many of the diabetics who suffer from foot problems may eventually wind up at this point without proper care for both their diabetes and the peripheral conditions it causes. A full 20 percent of diabetic hospital admissions are related to foot conditions, and the rate of readmission is very high.
All of the health problems caused by diabetes can be serious, and the complications that can arise from diabetic foot are potentially life threatening. Treatment techniques like PICC line medication can save a diabetic's life, but the only way to avoid such problems is to stick to proper and thorough diabetes treatment starting from the time of diagnosis.
Care+Wear is committed to helping you get back to living your life. Thank you Louis for sharing this wonderful post and please let us know any other topics that you would like featured on our blog!
About the Author
Louis Venter is the creator of diabetescoop.com, a website devoted to providing support and on-topic, frequently updated information for diabetics and those in their support network.
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