April 3, 2001
Question from Indianapolis, Indiana, USA:
If a person in her 40s who has type�1 diabetes sustains a fracture necessitating an open fixation reduction, would she have an increased risk of circulatory problems as she ages?
This is a hard question to answer, not knowing any of the history. For instance, a well controlled patient with diabetes in the absence of microvascular complications should heal if blood sugars are controlled. On the other hand, a person with diabetes for a long time may have compromised circulation to the area that needs to heal. The best bet is to be aggressive with blood sugar control during the healing process.
If the questions centers around circulation, it appears to me that this should be okay unless the surgical repair or the original injury damaged the blood vessels to the more dependent portion of the foot. In other words, I do not think a fracture should cause circulation problems unless the blood vessels were damaged in some way.