June 12, 2000
Question from Illinois, USA:
My brother is hospitalized with a severe leg infection at his left ankle. He is 42 and has had Type 1 diabetes since he was 19. He is being told this seems to be a strep infection, but after a week of intravenous treatments, his ankle continues to be swollen and red. How typical is such an infection for diabetics, what is the course of this, prognosis, and treatment(s)?
In diabetes, when feet or legs are concerned, one must be very careful because things can go from bad to worse very quickly. The finding of a diabetic foot or leg is typical of longstanding diabetic patients, most often in poor metabolic control and smokers. Neuropathy and arteriosclerosis play a major role towards diabetic lesions of the lower limbs. Infections are a due consequence of the worsening of the two previous pathological processes and the immediate treatment is directed to control the infections and to optimize metabolic control. Later, the treatment and prognosis depends on the severity of vascular and neurological lesions.