Gangrene and Diabetes: Know the Facts

Medically reviewed by Tyler Walker, MD on April 25, 2016Written by Traci Angel

What is gangrene?

Gangrene is a condition that occurs when your body tissue dies. This can happen when the blood flow to an area of the body is disrupted. Often, gangrene is the result of an injury or an infection of the skin and soft tissue.

Gangrene typically affects the toes, fingers, and limbs. It can also affect your muscles or organs, but this isn’t as common. This condition is generally characterized by discolored skin, feelings of numbness, and unusual formation of discharge or pus.

If you develop gangrene, you should seek immediate medical attention. Urgent care is needed to remove the dead tissue and prevent the bacteria from spreading through your bloodstream. If left untreated, gangrene can lead to a life-threatening infection.

What’s the link between diabetes and gangrene?

If you have diabetes, you have an increased risk of developing gangrene. High blood sugar levels can damage your nerves, which can cause a loss of sensation in the affected area. This can make it easier for you to develop an injury.

High blood sugar can also affect your blood vessels and limit the blood flow to your feet. This causes a chain reaction. If your feet aren’t getting enough circulation, fewer infection-fighting cells are making their way to your feet. If you don’t have enough of these cells in the area, any wounds you develop can take longer to heal. Any potential wounds are also more likely to be infected.

Check out: Tips for treating diabetic nerve pain »

Other risk factors to consider

You’re most at risk for developing gangrene if you have an underlying medical condition that affects your circulation. There are several conditions that affect the blood vessels and can increase your risk, such as diabetes. Other conditions include:

  • peripheral arterial disease
  • atherosclerosis
  • Raynaud’s phenomenon

If you’ve recently had a surgery or experienced a traumatic injury, you also have an increased risk of developing gangrene.

Minor infections in people with weakened immune systems can also become more serious and lead to gangrene. Weak immune systems can be caused by:

  • diabetes
  • chemotherapy
  • HIV
  • malnutrition
  • kidney failure
  • being over the age of 60

Types of gangrene

There are several different types of gangrene, and each has its own cause.

Dry gangrene

This form can happen when blood flow is blocked in a given area of the body. Your blood carries oxygen to different parts of your body. All of your organs need oxygen to survive. If one of your body parts isn’t getting oxygen through your blood, it can deteriorate and die.

The affected area is often characterized by a dark green or purple, almost black color. The skin may be dry and wrinkled due to the lack of oxygen.

Wet gangrene

Like its name, wet gangrene has a wet appearance. This type is characterized by blisters and swelling. Wet gangrene typically occurs in people who have frostbite or experience a severe burn.

People with diabetes may unknowingly develop wet gangrene after experiencing a minor toe or foot injury. Blood flow to the extremities is generally diminished in people with diabetes. This means that the tissue in these areas is unable to heal as quickly. As a result, infection can develop more easily.

Wet gangrene can spread quickly and, if left untreated, can be fatal.

Gas gangrene

This type usually occurs from an infection that develops deep inside the body. Harmful bacteria release gas, damaging tissue, cells, and blood vessels.

Gas gangrene can appear at an area of trauma or recent surgery. Your skin may swell and appear brownish-red in color. The gas may cause your skin to have a “bubbly” appearance.

Gas gangrene is an especially deadly form of gangrene, as it can develop suddenly and without warning.

Internal gangrene

Internal gangrene can develop when blood flow to an internal organ is blocked. This commonly affects the intestines, gallbladder, and appendix. If this occurs, you may experience severe pain and fever.

Fournier’s gangrene

This form of gangrene is restricted to the genital organs. It’s caused by an infection in the urinary tract or the genitalia. This is often characterized by pain, swelling, and general tenderness in the genital region. Often, the tissue will appear purple, green, or even black and have an extremely foul smell. Although this primarily affects men, women can also develop Fournier’s gangrene.

Progressive bacterial synergistic gangrene

This rare type of gangrene can develop after a surgery or operation. Skin lesions can develop around the affected area one to two weeks after your surgery.

How is gangrene diagnosed?

You doctor will discuss your medical history and perform a brief physical examination. Be sure to tell your doctor about any recent trauma, injuries, or wounds that you may have had. These could be the source of the condition. After you’ve discussed your symptoms, your doctor will likely perform one or more laboratory tests.

Blood tests can determine whether your white blood cell count is higher than normal. This could indicate an infection. An image test called an arteriogram can look at your arteries to see how blood is flowing and pinpoint any disruptions. Other image tests, such as an X-ray, a CT scan, an or MRI, can show where gangrene has spread.

If internal gangrene is suspected, you may need a surgical examination to confirm your diagnosis.

How is gangrene treated?

If you have gangrene, it’s important to remove the infected tissue as soon as possible. This can prevent the gangrene from spreading to other parts of the body.

Your doctor may perform a debridement. This involves surgically removing the affected tissue. Your doctor may also recommend a skin graft to repair the damage from gangrene and any defects left after debridement. A skin graft is a form of reconstructive surgery. Healthy skin is removed from a nondescript area on the body and used to replace the damaged skin.

In extreme cases, your doctor will recommend for the foot, toe, finger or place of infection to be removed or amputated. Antibiotics are necessary to fight off any infection.

How to prevent gangrene

There are several things that you can do to reduce your risk of developing gangrene. If you have diabetes, you should regularly check your hands and feet for lesions or signs of infection.

In general, you can reduce your risk by:

  • Paying attention to your weight. If you’re overweight, it can cause undue stress on your arteries. This can restrict blood flow, which can increase your risk of infection.
  • Dressing for the elements. It’s important to stay bundled up in cold weather. Frostbitten skin can lead to gangrene. If skin is abnormally pale, cold, or numb after being exposed to the cold, you should seek medical attention.
  • Quitting smoking. Long-term use of tobacco weakens blood vessels and can make you more likely to get gangrene.

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