
Dr. Abhijit Joshi explains how people with Diabetes have a higher risk of bone infection.
Increased risk of bone infection
People with Diabetes are at high risk for developing infection of the soft tissue and bones of the feet as a consequence of
When infection sets in the bone it is called as osteomyelitis.
Managing daily activities
Complications of Diabetes include:
Note: A confirmed diagnosis of osteomyelitis in the bone increases the chance of treatment failure and also increases the possibility of amputation of the affected area.
Signs and symptoms of osteomyelitis
The symptoms of acute osteomyelitis, which is quick occurring, are
In chronic osteomyelitis, symptoms often develop more gradually and include
In people with Diabetes, there are very few signs and symptoms to indicate the presence of chronic bone infection; one indication being a non-healing wound which heals and again breaks down.
Confirming a diagnosis of osteomyelitis is essential
To confirm a diagnosis of osteomyelitis the following steps are taken:
Treatment of osteomyelitis
Depending on the stage of the infection and severity, the treatment can range from non surgical to surgical and often is a combination of the two.
The wound is cleaned with antiseptic solutions. The foot is protected in a plaster and the patient is advised not to bear weight on the foot. A walker or crutches is recommended until the wound heals and infection is eradicated.
High sugar levels act as food for the germs and they thrive happily in such an environment as they develop resistance to the antibiotics, which need to be administered for a long duration ranging from six weeks to one year.
After a positive confirmation of the diagnosis, laboratory test are done and the germ is identified and its susceptibility to antibiotic is determined. Usually a combination of antibiotics is given as often there is more than a single type of germs causing bone infection.
Hyperbaric oxygen therapy is sometimes given to help in the healing of the wound.
In severe cases, surgery is recommended and the infected bone and surrounding tissue has to be removed from the foot in order to treat the infection.
Dr Abhijit Joshi is Consultant Orthopaedic and Diabetic Foot Surgeon at Chellaram Diabetes Institute, Pune.