Gangrene in diabetes is a process of necrosis of local tissues in the body, as a result of which infection of viable tissues is observed. Cadaveric substances also penetrate into the blood, which leads to an aggravation of the situation - a strong defeat of the internal organs of the diabetic is revealed - the liver, heart, lungs.
A late call to the doctor, inadequate treatment, an unhealthy lifestyle, and ignoring the problem lead to only one outcome - this is a radical method of therapy that involves amputation of an extremity.
Against the background of diabetes, the lower extremities most often suffer. A diabetic can develop gangrene of the foot, one phalanx, it can affect all fingers, if left untreated, and the longer, the worse. If you do not consult a doctor in time, diabetic gangrene will actively progress, which will lead to amputation of the leg to the knee.
It is necessary to consider the causes of such a pathology, to find out the signs of gangrene in diabetes. In addition, you need to find out whether it is possible to prevent the process, and how to cure gangrene without amputation?
Why does gangrene occur?
Knowing what gangrene is, you need to find out why it can occur. The development of gangrene in diabetes can be based on a wide variety of reasons. However, in the vast majority of situations, gangrene develops as a result of several causes simultaneously.
The ischemic form of gangrene is a consequence of atherosclerotic changes in the body, as a result of which the blood vessels are clogged, which leads to an upset blood circulation. As a result, the tissue does not receive enough blood and oxygen, death occurs.
A diabetic foot is characterized by the development of ulcers on the legs or foot, and if they do not heal for a long period of time, in addition an infection joins, the appearance of gangrene of an infectious nature is diagnosed.
There are other reasons that cause gangrene in diabetics:
- A consequence of impaired glucose metabolism in the body is polyneuropathy, which develops in the cells of the central nervous system. Against this background, the microscopic vessels of the nerve trunks are affected, and premature aging of the cells is observed.
- With a violation of small vessels and a decrease in the permeability of the capillary walls, gangrene begins in diabetes mellitus.
- In violation of large vessels, against the background of atherosclerotic changes, blood clots form in the body - this is also a leading factor in gangrene.
- Tissue necrosis is a consequence of many factors such as uncomfortable shoes, obesity, a significant weakening of the immune system.
Diabetes mellitus, regardless of its type, is a direct threat for diabetics to get multiple complications. And gangrene for diabetes (photo), one of them.
Diabetics can develop trophic ulcers on their legs, and with low sensitivity, because the pain threshold has decreased, the patient simply does not feel any changes in his body.
Gangrene of the lower extremities with diabetes never develops at an early stage of pathology.
It can appear only in those cases if the pathology was diagnosed, at least 5 years ago.
Signs and symptoms of gangrene
A high level of glucose in the blood gradually poisons the body, as a result of which the nerve endings, which are responsible for the transmission of “pain”, die, control the susceptibility of the lower extremities.
Along with this, those nerve endings responsible for the release of sweat on the skin of the legs die, which leads to dry skin, cracks often appear. And since everything is natural, additional infections join the non-healing and open wound, which only exacerbates the situation.
Unfortunately, if a person has a late stage of gangrene, the effectiveness of medications in this case is reduced to zero. Antibiotics do not help, because they simply can not cope with the task, the bacteria develop resistance to them. And in this case, to avoid amputation of the limb, simply does not work.
The initial signal in the form of symptoms suggesting that a pathological process is developing in the body is practically absent, because the legs do not have the same sensitivity. However, the first signs of precursors that should make the diabetic anxious can be identified:
- Chronic fatigue of the lower extremities during movement, slight tingling in the foot, immunity of the legs to touch.
- Deformation of the foot, pain in the legs.
- Changing the color of the lower extremities, or feet, fingers. The skin is cold and red, it can be said closer to blue.
If you pay attention to such precursors in time, and begin to treat leg ulcers, then the prognosis is quite favorable. The main thing is to adhere to all the doctor's recommendations, to lead a correct lifestyle (nutrition plays an important role).
- In the affected area there is a constant pain syndrome, pain medication does not alleviate the patient's condition.
- Affected areas turn black or crimson, indicating that tissue necrosis has begun.
- There is no blood circulation in the affected area.
- There is a complication: infection. This is especially true for cases of wet gangrene.
- Purulent masses are released from the wound, intoxication of the body is detected.
Unfortunately, it is quite difficult to stop the process that has begun, but it is possible if the patient consults a doctor on time and not alternative treatment at home.
The attending physician, without fail, conducts a visual examination of the limb, recommends a bacteriological study, tests for sugar, a blood and creatine analysis, and an ultrasound examination of the blood circulation in the body are prescribed.
Types of Complications
In diabetes mellitus, two types of gangrene develop: dry gangrene and wet (wet) gangrene.
Dry gangrene develops in those situations when the patency of blood vessels is gradually reduced. Such a process can last 2-3 years. During this period, a person can live quietly without feeling a change in his body, and the body, in turn, adapts to such a pathology, develops protective functions.
In the vast majority of situations, dry gangrene appears on the toes, infectious processes do not join.
This kind of gangrene is characterized by the following symptoms: severe pain in the legs, which subsides over time. During external examination, the affected area has noticeable differences from healthy areas, there is no smell. The wound does not affect the general state of health.
As a rule, there is no danger with this type of gangrene, and the leg can be amputated only by cosmetic indicators. Or in cases where there is a 100% risk of going into the wet form of gangrene.
Wet gangrene is characterized by the following:
- If the patient has a diabetic foot, then the addition of bacteria is a matter of time, they begin to multiply rapidly, as a result of which the affected area increases.
- The limb in appearance can be characterized by the word "cadaveric", the disease progresses rapidly, healthy tissue is affected.
- An unpleasant smell is felt from the infected area, the wound is always wet, and will not dry out.
- Poisoning occurs, as many cadaveric substances have entered the bloodstream.
With wet gangrene, the subcutaneous region during the infection of the tissues is filled with hydrogen sulfide, so when you click on the wound, you can hear a certain sound.
It is worth noting that this type of gangrene is not treatable, it is almost never possible to save the leg, and the best way out of this situation is to amputate the limb.
How to treat gangrene?
Treatment of gangrene with diabetes can be carried out in two ways - this is surgical intervention and conservative therapy. However, the most effective treatment will be surgery.
Through conservative treatment, the doctor tries to obtain compensation for the disease, reduce the load on the legs (especially the affected area), use antibiotics to reduce the spread of infectious processes, and reduce the poisoning of the patient's body.
During conservative treatment, vitamins for diabetics and complexes of mineral elements are recommended, which strengthen the human immune system and increase its natural barrier functions.
The surgical method is the main treatment for wet gangrene, and the only option that will help to avoid death. Along with the mechanical removal of dead tissue, the following actions are carried out:
- Antibacterial therapy through broad-spectrum antibiotics.
- Symptomatic therapy that reduces body intoxication.
- Blood transfusion.
Many patients are interested in how much they live with such a sore? Dry gangrene does not affect the life expectancy of a person, and in very rare cases it causes the death of patients.
However, the patient may die from pathologies that led to this condition. For example, in the elderly, the development of gangrene is the result of atherosclerosis, which can lead to death.
As for the wet type of pathology, without adequate treatment, a person’s life will last no more than three days, and every hour counts. It is worth noting that it will not be possible to cure the disease at home, no gangrene ointment can cope with it, as well as massage for diabetes.
Pain in the legs with diabetes is the eternal difficulty of patients, especially for people who have exactly 2 types of pathology. In order to preserve one’s health, to prevent the development of complications, it is necessary immediately after the diagnosis of the disease to begin prophylaxis.
It is necessary to abandon bad habits, which can lead to a disorder of full circulation in the body, which increases the likelihood of developing atherosclerotic changes and diabetic foot. All this along the chain can be the result of gangrene.
When a callus is found on the foot, adhesive plasters, that is, sticky products, cannot be used. When removing the adhesive patch, there is the likelihood of removing the upper layer of the skin, which will lead to a wound susceptible to infection.
Shoes are of no small importance. Inconvenient shoes or shoes can lead to the development of gangrene on the legs. It is necessary to wear only comfortable shoes, it should not press and rub, crush, etc.
In the summer, you need to be the owner of several pairs of shoes, and you need to wear it in turn, then clean it without fail. Every day you need to inspect your legs for damage and wounds, special attention is paid to the interdigital area.
Prevention consists in many points, and only their strict observance will allow you to save your health and prevent the development of a diabetic foot. Blood sugar control, lower limb care, and a healthy lifestyle will minimize the risk of complications. The video in this article offers a way to treat gangrene.
Forms of Diabetic Foot Syndrome
There are 3 forms of diabetic foot syndrome:
- Neuropathic form. Nerve damage predominates. As a result, sensitivity decreases, the skin becomes dry, muscles atrophy. The foot is damaged faster, trophic ulcers appear, and due to the reduced pain sensitivity the patient does not notice this.
- Ischemic form. Vascular damage predominates. Pain in the calf muscles appears when walking. The skin of the legs becomes pale, cold, hair falls out. Perhaps the development of gangrene.
- Mixed form.
With a slowly developing violation of blood flow, the tissues of the foot die, lose moisture, dry out, wrinkle. Blood from the vessels enters the surrounding tissues, is destroyed to iron, causing a dark color of the dead areas. At the border with healthy tissues, inflammation appears. Dry gangrene begins with severe pain below the blockage of the artery. The finger becomes pale, cold, in the future - cyanotic, then blackens or turns purple. If medical care is not provided, the process spreads higher to the level of sufficient blood flow. Sometimes spontaneous amputation can occur at the border with healthy tissues - rejection of damaged tissues. Dry gangrene is more common in thin people.
It occurs with a sharp violation of blood flow, more often against the background of edema, lymphostasis, in people with obesity.
It is characterized by infection, leading to severe intoxication of the body.
It starts with blanching of the skin. Then red spots and bubbles appear on it, filled with transparent contents. The leg swells quickly, hurts, then loses sensitivity. The infection joins, the process of decay starts. This is accompanied by intoxication of the body: body temperature rises sharply, chills, palpitations, sweating, lethargy, lethargy appear. The condition poses a threat to the life of the patient.
Treatment of gangrene of the lower extremities with diabetes
With developed gangrene of the lower extremities, the only treatment that can save a life is the amputation of the affected area. With wet gangrene, amputation is carried out urgently, since infection can lead to sepsis and death of the patient.
With dry gangrene, preoperative preparation is carried out aimed at improving blood flow above the level of the lesion, normalizing blood sugar levels, the functions of vital organs, fighting the infection, and adequate pain relief for the patient.
Amputation volume depends on the type of gangrene and the state of the vessels and surrounding tissues. More often amputation of fingers, one or several, less often - feet, and very rarely - "high" amputations at the level of the thigh or lower leg.
To prevent gangrene, as well as its relapse, reconstructive and non-reconstructive operations on the vessels that restore blood flow in the damaged sections of the arteries are of great importance. Arterial prosthetics, bypass surgery, angioplasty, stenting are performed.
In no case should you try to treat leg gangrene with diabetes with folk remedies, hoping to do without amputation, do compresses, rub ointments, warm, etc. This is life threatening, you can lose time, the pathological process will progress and lead to more operation.
Forecast for gangrene of the lower extremities
The prognosis for gangrene of the lower extremities in patients with diabetes depends on the type of gangrene, the duration of the disease, the age of the patient, the state of other organs and systems of the body, and compensation for carbohydrate metabolism.
With dry gangrene, the prognosis for life is favorable with timely treatment.
With wet gangrene, the prognosis is doubtful, worsens in elderly patients with diabetes mellitus, procrastination in seeking medical help. The prognosis for wet gangrene without treatment is unfavorable, the patient dies from the manifestations of toxic toxic shock.
Prevention of gangrene in diabetes mellitus consists in normalizing indicators of carbohydrate metabolism, cholesterol, normalizing blood pressure, eliminating bad habits, regular foot care, timely treatment of early manifestations of diabetic foot syndrome, unloading the foot if necessary.
Maintaining normal carbohydrate metabolism is the basis for the prevention of all complications of diabetes.
It is necessary to monitor the level of glucose in the blood at home daily with a glucometer. Twice a year, and if necessary more often, check the level of glycated hemoglobin, which indicates compensation for diabetes mellitus. Do not forget about the daily diet and regular intake of sugar-lowering drugs or insulin injections.
Often in patients with diabetes, lipid metabolism is also impaired, cholesterol, its fractions and triglycerides are elevated. Normalization of these indicators slows the development of atherosclerosis and improves the condition of the vascular wall.
Bad habits exacerbate diabetes. Hypodynamia contributes to the development of obesity, increased blood glucose, muscle atrophy. During smoking, vasospasm occurs, which further enhances circulatory failure in the affected tissues. Alcohol abuse causes severe hypoglycemic conditions, worsens the condition of the pancreas and liver.
Regular foot care and exercise are what every diabetic should do regularly.
Foot Care Tips
- Check your feet regularly. In the event of corns, calluses, cracks, ulcers, changes in the condition of the nails (darkening, ingrowth, fungal infection), be sure to consult a doctor.
- Wash your feet daily with warm water and soap, you can make baths, but in no case do not steam out the feet. Gently wipe the corns and coarsened areas with a pumice stone. After washing, apply a moisturizer to the feet, avoiding the areas between the fingers.
- Carefully trim your nails, taking care not to injure your finger skin.
- Do not cut corns and corns with sharp razors, scissors, do not apply corn plasters.
- Wear comfortable shoes with a wide toe. Shoes should be appropriate in size, without extraneous inserts. If you encounter difficulties with the selection of shoes due to deformation of the fingers, contact the podotherapist with a request to select special orthopedic shoes.
- Perform exercises for the feet. They will strengthen muscles and improve blood circulation in the affected areas.
Timely initiation of treatment for diabetic polyneuropathy and angiopathy can significantly reduce the likelihood of developing gangrene. They use thioctic acid preparations, B vitamins, vascular preparations, antioxidants, drugs that lower blood cholesterol and thin the blood.
Symptoms of gangrene in diabetes at the initial stage
Given the specifics of the development of this disease, it is not always possible to establish the initial stage of vascular tissue damage in the lower extremities. At the same time, the fact that each patient develops this disease individually and a great influence is the level of sugar in the blood of the diabetic himself plays a big role. The higher the glucose concentration, the faster the progress of the disease. The following symptoms are usually attributed to the initial manifestations of diabetic gangrene.
Swelling of the legs
In most cases, necrosis begins with only one leg. Very rarely, the disease affects both limbs at once. Therefore, it is extremely important to pay attention to such manifestations as a feeling of intense fatigue and heaviness in the same leg area. The pathological sensation is enhanced when the patient is sitting for a long period of time, and the blood stagnates in the lower extremities.
In the place of future development of gangrene, sensitivity partially disappears. While touching the leg, a person feels a slight cold or numbness, reminiscent of an injection of many sharp needles at once. This indicates that the pathological process of cell death has already begun and nerve endings are involved in it, poor conductivity of which is a direct sign of the presence of the disease.
Muscle fiber pain
During movement and active muscle contraction, a patient with diabetes feels acute pain in the leg, which increases in proportion to the number of movements made. A similar symptom is manifested due to the fact that an inflammation center begins to form inside the tissues of the leg, which in the future transforms into sugar gangrene.
Skin color change
Before a full-fledged diabetic gangrene appears, first the skin changes its usual bodily shade to a lifeless pale. Under the surface layer of the epithelium, red and cyanotic blood capillaries, which are distinguished by the presence of obvious signs of damage and a characteristic vascular network, can only occasionally shine through. A visual examination and palpation gives the impression that blood does not flow to this part of the leg and this is due to the unsatisfactory state of the lower limb.
The diseased leg segment differs from the rest of the leg by the presence of a lower temperature. If you feel the affected foot, you will notice that its surface is several degrees colder. This symptom indicates that the blood in the cell of this part of the limb does not enter the required volume and the cells of epithelial tissues are deficient in nutrients.
If the situation does not change, then they begin to die in large numbers and the process of necrosis develops.
The last stage and pathological symptom of diabetic foot gangrene is redness of pale skin with the onset of irreversible changes in the structure of diseased tissues. Further signs of the disease develop, which already belong to the later stages of the disease and are not related to its primary symptoms. These include an increase in the patient’s body temperature, chills, fever, lack of appetite, headache, nausea, and the release of copious vomit from the stomach.
The surface of the leg becomes saturated crimson and in a few days changes to a black tint. This part of the limb is no longer supplied with blood and tissue is actively disintegrating. Against the background of impaired skin integrity, a bacterial infection enters the body, which only enhances the symptoms of the disease. From the foot, pus and anemia begin to stand out. A person suffering from diabetes experiences severe physical pain and needs regular painkillers.
The smallest blood vessels capillaries are very thin and fragile. Any effect on their structure leads to multiple damage and brittleness. Diabetic atherosclerosis is caused by the fact that crystals of excess sugar in the blood clog the vascular ducts and interfere with normal blood circulation. This is one of the most common causes of gangrenous lesions in the legs with diabetes.
This is the so-called wet gangrene, when a watery blister forms in the heel area, which most patients confuse with rubbing the surface of the skin. Only when it bursts does it become clear that in fact this is a lesion of the limb associated with a violation of blood circulation. A bacterial infection gets into an open and long non-healing wound and gangrene develops, which in fact is no longer the main, but a concomitant disease.
Violation of the metabolic process of glucose uptake by cells located in the nerve endings responsible for the sensitivity of the lower extremities. In the presence of this pathology, neurons die several times faster, premature aging and death of nerves occurs, and ulcerative formations on the leg are localized precisely in the places of their passage. This cause of the disease occurs much less often than all other factors, but it still occurs in medical practice.
Decreased local immune system
Immune cells are among the first to respond to excessive levels of glucose in the blood. In patients with diabetes mellitus, due to the excess sugar concentration, the immune system becomes weakened and does not fully fulfill the protective functions assigned to it. Against this background, even minor damage to the finger, heel or other part of the foot becomes an open gate for any type of pathogen. If Staphylococcus aureus or streptococcal infection has got into such a wound, then the likelihood of developing gangrene is very high.
In diabetics, the blood is much thicker than in people who do not suffer from this disease. This is because sugar crystals make the body fluid more viscous. It becomes harder for the heart to pump blood through blood vessels with narrow walls and eventually small thrombi form first, and then they become more dense and voluminous in size. The presence of a blood clot in a vein is a direct path to the lack of blood supply to other parts of the leg located downstream of the bloodstream and the prospect of diabetic gangrene.
The level of physical activity of the patient is also of great importance. It is scientifically proven that in diabetics who move throughout the day, they perform elementary work, load their body with moderate physical exercises, signs of gangrenous lesions of the legs are 3 times less common than in patients who prefer a sedentary and sedentary lifestyle.
The stages of gangrene in diabetes mellitus and prognosis
This disease is divided into several stages, each of which is distinguished by its own clinical picture of the course and characteristic symptoms. The following stages of diabetic gangrene of the lower extremities are distinguished.
In most cases, the patient does not feel pathological signs that he develops this disease. There are only minor changes in the color of the skin (it becomes pale), the leg has a lower temperature, slight tingling in the area of the affected area of the foot is possible.
At this stage, the first signs of the death of damaged epithelial cells and soft tissues are manifested. The inflammatory focus is not yet so extensive and is mainly concentrated in muscle fibers without reaching the surface, but the skin on the leg is already becoming red and hot. At this stage, the disease is still successfully treatable without amputation and does not require a long period of therapy.
The stage of the acute phase of the development of the disease, when the process of cell breakdown is started inside the leg and the first ulcers form on the skin. The wound may be single or manifested in the form of multiple neoplasms. This stage of the disease is already considered a life-threatening diabetic and the prospect of preserving the leg, but with an effectively formed course of treatment, it is still possible to save the limb.
The final stage of development of gangrene caused by a complication of diabetes. The epithelium on the leg blackens, and the tissues under it stop receiving blood supply. The leg in the literal sense of the word begins to rot, and exudate stands out from the skin, characterized by a rich yellow tint and an unpleasant odor. Against this background, a bacterial infection from the environment enters the wound surface and only enhances the symptoms of the disease. This period of the disease requires the attending physician to take radical measures of therapy, which in most cases is the amputation of part of the foot. Only in rare cases can a limb be preserved.
Each of the listed stages requires a separate treatment technique, since the patient’s body still resists the disease and, with all possible efforts, tries to provide clogged cells and blood vessels with all the necessary nutrients.
The best dynamics for recovery is observed in diabetics who are receiving treatment with stages 1 and 2 of the development of gangrene. The prognosis is, of course, favorable, but only if treatment is started on time. At stages 3 and 4 of the disease, it is extremely difficult to restore the functioning of the limb. It is even more difficult to prevent the risk of gangrene recurrence in the same area of the leg, when blood supply to the vessels is already disturbed. Here you can read about the symptoms of gas gangrene.
The timely passage of diagnostic procedures and a comprehensive examination of the body plays an important role in the formation of a further course of therapy on the way to the full restoration of the working capacity of the sore leg. For this, the patient is prescribed for delivery the following types of tests:
- blood from a vein for biochemical research for a change in its qualitative composition, which is quite possible against the background of an acute inflammatory process that occurs inside the foot,
- blood from a finger to determine and further control blood sugar levels (especially important in those clinical cases where the patient has been unable for a long period of time to lower the glucose concentration in the body with medication),
- smear from the wound surface, if the gangrene has already reached the stage when ulcers have formed on the skin or diabetic foot syndrome has developed (selection of biological material on a sterile cotton swab is necessary so that physicians have the opportunity in the laboratory to establish a strain of bacteria that provoke purulent inflammation in tissues of the lower limb),
- giving urine allows you to determine the condition of the kidneys of a sick person, as they also suffer from excessive sugar levels, and their tissues are damaged in the process of cleaning viscous blood saturated with sugar crystals.
These are basic tests that are mandatory for passing to a patient with diabetes mellitus, in which physiological prerequisites for the formation of dry gangrene or with signs of a wetting process are found.
If the damage to the skin is critical and the attending surgeon has a suspicion that the disease has already managed to reach the bone tissue, then the patient is additionally prescribed an x-ray. This diagnostic method will allow you to find out if the leg bone is involved in the inflammatory process.
Treatment of gangrene of the lower extremities with diabetes
Modern methods of treating sugar gangrene have long stepped forward and are based on the results of recent scientific research and discoveries in the field of combating the manifestation of complicated forms of diabetes. This kind of treatment is conditionally divided into conservative, when exclusively drug therapy with drugs is used without surgical intervention and surgical. Recent manipulations include local debridement of the wound surface and inflamed tissues, or partial amputation of the leg.
In general, surgeons use the following methods to rid patients of signs of diabetic gangrene:
- intramuscular and intravenous administration of broad-spectrum antibacterial drugs so that the pathogenic microflora present in the ulcer formation does not increase its population and does not exacerbate the already acute clinical picture of the disease (the type of antibiotic is selected individually in each case),
- blood transfusion (effective in cases when gangrene has reached stage 4 and an excessive amount of toxins poisoning the body, as well as threatening blood poisoning, is found in the patient’s blood),
- intravenous droppers with the introduction of drugs that provide quick cleaning of the lymphatic fluid and blood from toxic substances resulting from decay of the flesh of the lower limb,
- the use of vitamin and mineral complexes that stimulate a more active activity of the cells of the immune system, which is extremely important in the presence of an acute form of the inflammatory process in the tissues of the leg,
- subcutaneous administration and adjustment of insulin doses to reduce the level of glucose in the patient’s blood (this is the main and main task, so that in the future sugar crystals do not clog the blood vessels anymore, causing a clinical aggravation of the disease),
- the application of local anti-inflammatory and antiseptic ointments, which provide more accelerated wound healing and regeneration of damaged tissues,
- intravenous administration of painkillers, most of which are potent narcotic drugs (only medications of this category can stop the pain syndrome for a short period of time and alleviate the suffering of a patient with diabetes mellitus with signs of gangrenous foot damage),
- surgical opening of a purulent formation, partial excision of dead soft tissues that acquired a crimson or black hue and no longer fed on blood.
By promptly seeking medical help, doctors manage to ensure the preservation of the limb solely due to the fact that in the operating room the surgeon, using medical instruments, cleans the wound formation from pathogenic microflora and leaves only those tissues that show live dynamics. An extreme method of treatment is the amputation of a part of the lower limb, which cannot be saved for objective reasons established during the diagnostic measures. There are alternative methods of treating gangrene, but we do not recommend that you self-medicate with such a serious diagnosis.
Complications and consequences
Diabetic gangrene is a serious disease that entails the onset of no less dangerous consequences. In the case of an incorrectly formed therapeutic course, or as a result of too late seeking medical help, a diabetes patient may develop the following complications:
- sluggish inflammation in the tissues of the affected lower limb, which is aggravated in its manifestation, begins the death of cells from the thumb and gradually progresses,
- amputation of a small part of the foot or three quarters of the leg (it all depends on how quickly the disease spreads in the tissues of the limb and what level of blood sugar is present in the patient),
- the onset of blood poisoning with a large number of bacterial microorganisms, which in a short period of time increased their numerical population inside the sore leg and, together with the blood stream, spread throughout the body, overcame the immune barrier and destroyed blood cells,
- septic shock, which in 95% of cases ends with the patient entering a coma with a further fatal outcome,
- the development of chronic immune deficiency against the background of the fact that the body no longer provides the implementation of its protective function under the influence of acute bacterial inflammation in the tissues of the leg, initially provoked by diabetic gangrene.
The most terrible consequence of all the above complications, of course, is the loss of part of the limb and the onset of disability. Death is also not the best outcome, but mortality does not entail suffering on the part of the patient and adaptation to a new lifestyle with limited mobility.