Why diabetes increases burn risk, and tips to stay safe

by Laura S. Johnson, MD, Burn Surgeon
November 28, 2017

Burns can happen to anyone, but people with diabetes may be more susceptible than others. In fact, between 10 and 15 percent of patients admitted to our Burn Center have diabetes.

High or unstable blood sugar levels, the hallmark of diabetes, can damage your nerves and blood vessels. This can cause poor circulation, which can leave you feeling cold, particularly your feet.

We often see patients who were burned trying to warm their legs and feet using hot water and heating pads or by propping them up against heaters and radiators. In the summer, we see people who burn their feet walking barefoot on very hot concrete.

Damaged nerves cause you to lose feeling, so you may not be aware you're being burned. And it also leaves your body less able to fight infection and heal from a burn.

Even a small burn can quickly get out of control, and one in 10 patients  with diabetes who burn their feet requires amputation. But by following a few simple tips to prevent burns and seeking immediate treatment when one occurs, we can better thwart these types of outcomes.

Tips to prevent burns when you have diabetes

There are a few simple things you can do to avoid burn injuries:

  • Set a timer when using a heating pad. This will ensure you don’t accidentally leave it on too long or fall asleep with it on. It’s also a good idea to put a piece of cloth/clothing between the pad and your skin.
  • Avoid sitting too close to a warming device, such as a heater, radiator or fireplace. They can be hotter than you think and cause mild or severe burns.
  • Check water temperature with a thermometer or your elbow or sensitive body part, such as the elbow. And don’t use Epsom salts to increase the boiling point of water and allow it to retain heat longer.
  • Avoid walking barefoot, even in the house, and particularly in the kitchen.
  • Inspect your feet regularly for burns and wounds.

Also, maintain proper glucose levels and practice good diabetic foot care. I can’t stress enough the importance of regular visits with your primary care doctor to manage your diabetes. This is also a key time to bring up any new symptoms, such as, “My feet are cold all the time now.” Your doctor also should inspect your feet during these visits and discuss foot care.

Unfortunately, I see many burn patients with diabetes who had no idea they should be doing anything special regarding their feet, such as inspecting them regularly, wearing sensible shoes or taking extra care when cutting their toenails. Diabetic foot education is incredibly important for all patients to avoid serious diabetes injury or illness.

Read more: Prevent diabetic foot problems with these easy care practices

If you discover a burn that is not healing, contact your doctor immediately and, if possible, go to a burn center for treatment.

Treating burns in people with diabetes

Burn patients with diabetes often seek treatment late—many people don’t even notice their burns right away because of lost nerve sensation in the affected area. We’ve seen patients come in anywhere from six hours later when they notice blisters forming to weeks later when they seek treatment for a seemingly unrelated problem caused by infections from the burn.

Early treatment for burns is important for anyone, but especially for people with diabetes due to their problems with healing. According to a 2015 study, patients with diabetes had to stay in the hospital on average 21 days for burns, compared with patients without diabetes who stayed an average of nine days. They also had more complications, including regrafting and amputation.

Because of this, it’s beneficial for these patients to seek care at a burn center. People often ask, “There’s a hospital or clinic down the street from me. Can’t I just go there for treatment?” But burn injuries are unique, and there are nuances to treating them that not every health facility is used to managing. Similarly, diabetic foot management requires specialized knowledge as well.

Read more: When to seek treatment at a burn center

Multiple teams coordinate on a diabetic patient’s burn care. Along with burn surgeons, physical therapists, dietitians and social workers, your team also may include endocrinologists to improve diabetes management and vascular specialists to evaluate and enhance blood flow in the area of the burn. Once the burn injury is stabilized and healing, you may be able to get follow-up care closer to home. But for that crucial initial treatment, a burn center will give you the best chance at optimal healing and preserving the limb.

If you’re due for a diabetes checkup or foot exam, request an appointment today. Be sure to ask your doctor what you can do at home to keep your feet warm, safe and burn-free.

 

Category: Healthy Living     Tags: burnsdiabetesdiabetic footDr. Laura Johnson