I Have Diabetes. Can I Have Surgery?

The answer to the question posed in the title of this article is not a simple yes or no.  Diabetes is a complex illness that affects multiple systems in the body.  While many people’s loose understanding of Diabetes revolves around insulin, sugar, and nutrition, few realize how extensive it is.  In fact, diabetes has significant effects on the body’s ability to heal and to repair itself after trauma, and that includes surgery.

Wound Healing

When the body sustains an injury or a wound, it undergoes different phases of healing.  These phases involve complex cellular mechanisms that promote growth of blood vessels and tissue regeneration.  These phases of wound healing progress from stage to stage until the wound resolves.  In diabetes, wounds often become chronic wounds, arrested in one of the stages, often the inflammatory stage.

Why do Diabetics have poor wound healing?

As mentioned previously, Diabetes affects multiple systems.  It is often associated with damage to blood vessels, nerves, and immune system function.  This combination challenges the bodies ability to progress through the stages of wound healing. 

In many cases, diabetic individuals have decreased blood flow to the lower extremities known as Peripheral Artery Disease.  This lack of blood flow inhibits the delivery of proper nutrients and cellular building blocks needed for tissue regeneration.  In addition, diabetics often have impaired cellular signaling to grow blood vessels to the site of the wound.

Furthermore, a lack of protective sensation from nerve damage greatly diminishes the individual’s perception of injury. We often take for granted the role pain plays in how we manage our wounds.  When we feel pain, we are more motivated to remain immobile, non-weight bearing, and more diligent in our compliance as patients.  Those who suffer from diabetes and who undergo surgery, must resolve to continually monitor their progress and to follow the doctor’s orders.  One of the key factors in successful diabetic wound healing is a motivated patient surrounded by a solid support system.

Conclusion

As you can see, a number of factors determine whether a patient with diabetes will respond well to surgery.  At times, surgery is unavoidable as in the case of accidental trauma; otherwise, elective procedures should be evaluated by your doctor to assess the risk vs. benefit of moving forward.  If you have diabetes, and are considering an elective foot and ankle procedure, don’t hesitate to schedule an appointment with Dr. Gary N. Friedlander or Dr. Jay C. Larson at Sole Foot and Ankle Specialists in Glendale, Arizona.

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