Correlation between Uncontrolled Diabetes and Osteomyelitis

Background

  • Osteomyelitis is a bone infection caused by an infectious organism.
  • Can affect any population or group.
  • Rare, but serious condition.

Incidence remained relatively stable among children and young adults but almost tripled among individuals older than sixty years.

this was partly driven by a significant increase in diabetes-related osteomyelitis from 2.3 cases per 100,000 person-years in the period from 1969 to 1979

to 7.6 cases per 100,000 person-years in the period from 2000 to 2009 (p < 0.001)

  • Furthermore, in the same study, diabetes was found to be associated with osteomyelitis in 27% of the patients, followed by 19% from trauma-related infections (open fracture with exposed bone coming into contact with bacteria).

The Correlation With Diabetes

  • If high glucose levels persist over a period of years, blood vessels can become damaged. This can lead to plaque forming in the blood vessels, making it difficult to deliver a sufficient amount of blood to neighboring cells.
  • Often, poor circulation occurs in the lower extremities, leading to…
  • Peripheral Artery Disease (PAD) – A circulatory condition in which narrowed blood vessels reduce blood flow to the limbs.
    • High incidence of >3 million cases in the US per year
  • For example, trauma to foot > foot ulcer > becomes infected > infection spreads to bone (osteomyelitis)

Correlation with Amputations

  • In the study, 68% of patients with diabetes-related foot osteomyelitis had an amputation.
  • This proportion is similar to those in other studies and remained relatively stable over the forty-one-year time period of our study, indicating that amputation is still relatively common once osteomyelitis develops.

Occupational Therapy Management and Prevention

  • Prevent Hyperglycemia
  • Feet care and awareness
    • Check feet for ulcers or injuries
    • Wash regularly
    • Apply lotion (but not between the toes) to help prevent dryness
  • First-Aid: wash and treat cuts to prevent infection
  • General Health and Wellness promotion
    • Smoking/drug cessation
    • Alcohol
    • Weight management through diet and exercise

Sources:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4642868/