Morbid Obesity Increases Chance of Developing Diabetes and Foot Ulcers

A published study shows morbidly obese patients are much more likely to develop diabetic foot ulcers than non-obese patients. Michael Pinzur, MD, Ryan Freeland, MD, and Danius Juknelis, MD, of the Loyola University Medical Center, conducted the study to measure the correlation between body mass index (BMI) and foot disorders in diabetic patients.

Dr. Pinzur documented the results of 133 patents that were admitted to the Loyal University Hospital for treatment of a diabetes-associated foot infection over a 66-month period. He was able to calculate BMI for 82 patients and he found that 56% of them were morbidly obese, defined by a BMI of more than 30 kg m2 according to the standards established by the National Institute of Health.

This is significantly higher than the prevalence of morbid obesity in the general population of the United States, which is currently 20.9%.

Morbid obesity increase the risk of cardiac-related disease, makes offloading of diabetic foot ulcers during treatment more difficult, and hampers rehabilitation after lower extremity amputation.

Currently sixteen million individuals in the United States have diabetes, and 15% will develop a foot ulcer during the course of their lifetime. Diabetic foot ulcers (DFU) look like red sores and can be seen during visual examination of the feet.

The abnormally high levels of blood sugar in diabetic patients damage blood vessels, causing them to thicken and leak. Over time, the vessels are less able to supply the body, especially the skin, with the blood it needs to remain healthy. The resulting poor circulation leads to ulcers, especially those located in the feet.

These ulcers are slow to heal and often become deep and infected. Unfortunately, ulcers can become so deep and infected that the foot needs to be surgically amputated. Yearly, 50,000 foot ulcers progress to eventually require a lower extremity amputation (LEA). More than one-third of these patients die within 2 years after a lower extremity amputation.

The results of this investigation substantiate the clinical concerns of the devastating effect of obesity on the welfare of the diabetic patient. Weight management, along with low glycemic diet, nutritional supplementations, and exercise makes control of blood glucose easier.

“The study simply supports the notion that diabetics should strive to loose weight, in addition to maintaining good sugar and lipid control,” said Dr. Pinzur. The investigation supports the notions that normalization of body weight might also decrease the risk of development of diabetic foot ulcers.

Published in the April edition of Foot and Ankle International (FAI)

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