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/