Veterans & Diabetic Foot Ulcers: A Review of Existing Research

More than 25% of veterans have been diagnosed with type II diabetes. That means 1 in 4 people receiving care at Veteran Administration (VA) hospitals are being treated for the disease. According to the U.S. government, service members who were exposed to Agent Orange have an increased risk of developing diabetes. Last year, the Detroit Free Press reported that the number of diabetes cases rose from 135,000 to nearly 323,000 in the past nine years. That’s more than 10% of the military personnel who went to Vietnam.

vietnam veterans agent orange

Diabetes is the most prevalent disease among Vietnam veterans.
Image Source: U.S. Navy Mass Communication Specialist Seaman Tristan Miller via

In fact, more Vietnam vets are receiving compensation for diabetes than for any other health issue, including post-traumatic stress disorder, hearing loss, or general wounds. The average veteran receives about $3,000 for diabetes care alone. Along with diabetes comes the risk of diabetic foot ulcers, which occur when pressure causes breaks in the skin and those slow-healing wounds become infected.

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Awareness and Prevention: How Do Diabetic Foot Ulcers Lead to Amputations?

The Amputation Prevention Centers of America says that nearly 1 in 5 diabetic foot infections require some sort of amputation. “If ulcers can be prevented, up to 85% of amputations may also be prevented,” says Dr. Francesco Squadrito, MD, of the University of Messina, Italy. It’s clear that diabetic foot ulcers many times result in amputations, but why? Shouldn’t we have more options for diabetic foot ulcer treatment in 2014?

diagram showing typical locations of foot ulcers

Foot ulcers usually appear on the bottom of the feet, but may also affect the toes.

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Take Strides to Protect Your Feet: 3 Reasons Diabetics Should Invest in Shoe Orthoses

People with diabetes can achieve the best possible health by managing the various risks they face. Poor circulation is one complication caused by elevated blood sugars. This condition makes it more difficult for wounds to heal — particularly wounds in the lower extremities.

Another complication — nerve damage — makes it possible for slow-healing wounds to go undetected for long periods of time. During this time, bacteria, viruses, and fungi can easily infect the wound. We wash our clothes daily, but fail to follow any regular protocol for our footwear — and yet, this dark, damp, warm environment is where pathogens like to procreate most.

To avoid dangerous diabetic foot infections resulting in hospitalization, surgery, and/or amputation, we recommend preventing foot wounds with orthoses and preventing microbial buildup with a SteriShoe UV shoe sanitizer.

diabetic orthoses

There are several different types of orthoses to choose from.
Image Source:

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The Dysvascular Foot & How It Leads To Infection

A “dysvascular foot” refers to a foot that has a defective blood supply. This condition is most frequently found in diabetics, and is directly caused by chronic heightened blood sugar levels which cause nerve damage over time. This nerve damage is called “neuropathy.”

According to FW Wagner,  dysvascular patients make up 80% of the thousands of patients who undergo lower extremity amputations. He created a scale to help doctors figure out how to determine the severity of a patient’s foot infection. Hopefully you will keep a close eye on your diabetic foot hygiene, so you never have to worry about such trouble.

wagner scale

FW Wagner created a scale to help doctors determine the severity of a dysvascular diabetic foot. Image Source:

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A Cautionary Tale: California Man's Mismanaged Diabetes Nearly Costs Him a Foot

Rick Maina’s nightmare began when he stepped on a thumb tack in the garage. The 53-year-old said he wasn’t too worried at first. He treated it with antiseptic and went on with his life for the next month. Then, on Labor Day weekend, he wore a pair of flip-flops to the beach and noticed that his previously injured foot began to swell up. “I maybe picked up some bacteria in the sand, and that caused it to become infected,” he said. At the time, he had no idea that his Type 2 diabetes had caused nerve damage in his feet. This true story shows how diabetic foot infections can quickly spiral into serious trouble.

diabetic foot infection

Wearing flip-flops to the beach can spell disaster for an uncontrolled diabetic with a small puncture wound.
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How Art Transforms Tragedy: Beautiful and Functional Prosthetic Legs Can Bring Hope to Diabetic Amputees

For many weeks now, we’ve chronicled the problem of diabetic foot infections, ulcers, and amputations. It can be a deeply troubling topic, especially if you have diabetes and are already on the lookout for foot wounds. So this week we thought we’d bring you something a little  more uplifting — a story about alternative prosthetic limbs that are blurring the line between art and medical science.

diabetic prosthetics

Bespoke Innovations out of San Francisco is breaking new ground with their line of unique prosthetics.
This leg belongs to athlete Sarah Reinertsen. Image Source:

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Shoe Shopping Tips for Diabetics: How to Choose the Best Shoes & Orthotics for Your Feet

For so many people, shoe shopping is one of life’s great joys, and yet so many of us take our footwear choices for granted. When we go shoe shopping, we’re more concerned with the color, the heel height, or whether the style is in fashion than we are with the level of support the shoes provide. However, for people with diabetes, choosing the right shoes can be a literal life-saver, and shopping for the right footwear can feel like a chore.

Proper and sanitary footwear is essential for people with diabetes, no matter what stage you’re in. Even the slightest degree of neuropathy can be troubled by the wrong shoe choice. One of the roles of a podiatrist is to ensure that you have the best possible shoes to protect your feet, so you can prevent serious foot complications like infection and amputation. Thankfully, we have some helpful advice to guide you in your shoe shopping.

diabetic shoes

Some people think Dr. Comfort shoes for diabetics are unsightly, but they are reported to be one of the more comfortable choices for diabetics. Image Source:

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Triple Amputee Recalls Important Diabetic Foot Symptoms She Missed

Nine years ago, 47-year-old Jane Knight led a busy life. The British mum looked after an autistic son and worked as a therapist. She loved to write, paint, play piano, and sew. Today she lives as a triple amputee after operations removed both legs and one arm. It wasn’t a tragic accident that claimed her limbs — but a common disease that 25.8 million Americans and more than 3 million Brits have: diabetes.

prosthetic legs

Prosthetic legs are not as glamorous as this photo would have you believe. Image Source:

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5 Ways Bacteria Can Infect The Feet

More than 80 types of bacteria have found a happy home on our feet. In fact, different types of foot fungus, bacterial colonies and microbes prefer to live in different places — some on the sole, some in between the toes, some on the tops of our feet. It really is a diverse, thriving colony. Gross, right? The reality is that this bacteria can’t hurt us just sitting there. The microbes need a pathway inside the body, where it can cause a wealth of disgusting and uncomfortable side effects. Here are five ways bacteria can cause a foot infection.

foot bacteria

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