General Infections [B]
Patients with undiagnosed high blood sugar may come into the office for the treatment of an infection. Infections are more likely in diabetic patients due to glycosylation of tissues that causes irritation and increases susceptibility to infection. Diabetics have an abnormal white blood cell defense, in which polymorphonuclear white blood cells have a decreased ability to perform chemotaxis, a reduced ability to degranulate, and a decreased production of free radicals that destroy infections. This makes diabetics more prone to infections, chiefly Staphylococcus, Streptococcus, and Candidiasis.
Foot Infections and Amputation [B]
Diabetics are especially prone to foot infections. As many as 25% of all diabetics will develop severe foot problems at some point in their lifetime. Half of all amputations in the United States result from diabetes. Diabetic foot infections are generally more severe and more difficult to treat than infections in nondiabetics. This is due to impaired microvascular circulation, neuropathy, anatomical alterations, and impaired immune capacity in diabetic patients. Most moderate-to-severe soft-tissue diabetic foot infections are polymicrobial (i.e., due to gram-positive, gram-negative, aerobic, and anaerobic pathogens).
Early detection and prompt attention by checking for signs of infection will significantly decrease the risk of serious complications. Although one would think that the vascular insufficiency is the main cause of diabetic foot ulcerations, it is actually the neuropathy. It is speculated that uneven pressure on the plantar side of the foot leads to microtrauma to the tissues, which allows the bacteria to enter and start reproducing. The patient will have no pain due to the neuropathy and thus continues to walk on it, further aggravating the condition. This eventually results in deep soft tissue and/ or bone infections.
Conventional Pharmaceutical Treatment [SH]
Antibiotic Therapy [C]
Antibiotic therapy often includes broad-spectrum antibiotics capable of covering the most common pathogens found in diabetic infections. Therefore, antibiotic therapy is nearly always active against staphylococci and streptococci, with broad-spectrum agents indicated if gram-negative or anaerobic organisms are likely. In infected foot tissues, the levels of most antibiotics are often sub-therapeutic. The duration of therapy ranges from a week (for mild soft tissue infections) to more than 6 weeks (for osteomyelitis).
Side Effects: Antibiotic therapy, especially broad-spectrum antibiotics, can, however, disrupt the normal flora of the gastrointestinal tract and vagina, leading to other symptoms, such as diarrhea, yeast infections, and thrush. In addition, other more serious opportunistic infections of the GI tract can occur, such as C. Difficile. This infection causes frequent diarrhea, cramping, and mucous in the stool. It has been associated with deaths due to opportunistic infection in hospitals. Broad spectrum antibiotic use is also associated with allergic reactions in humans, an increase in antibiotic resistant bacteria, and disruption of the immune system. Some antibiotics have been shown to disrupt oxidative phosphorylation in the cell mitochondrion, leading to fatigue. Of course, there are situations when antibiotic treatment is necessary. However, the treatments below can lessen or eliminate antibiotic use.
Naturopathic Medical Alternatives [SH]
There are many natural medicine alternatives to pharmaceutical antibiotics. Simple natural treatments can go a long way in preventing and treating diabetic foot ulcers.
General Infections
Like antibiotics, the natural treatments listed here should show symptomatic improvement within 2 days and need to be continued until 5 days after all symptoms have subsided.
| Organism | Infection | Natural Treatment |
| Streptococcus | Cellulitis | IV Oxidative therapy |
| Staphylococci | Arthritis | IV Oxidative therapy |
| Candida | Thrush, urinary tract infection | Thyme essential oil, garlic, |
| Klebsiella sp. | Urinary tract infection | Uva ursi, thyme essential oil, Mannose, buchu |
Hydrotherapy [C]
Hydrotherapy will also make sure tissues are being nourished by strong blood flow.
Botanical Medicine [C]
Horse Chestnut (Aesculus hippocastanum): This herb has a long folk history in venous support. It helps healthy circulation in the legs. It helps to control venous pressure, maintain vascular integrity, decrease damaging connective tissue within the vein, and prevent lipid peroxidation.78
Green Tea: Adding 3 cups of green tea a day to the diet will significantly increase capillary strength.
Clinical Nutrition [C]
Inositol Hexaniacinate: This supplement is also effective in peripheral vascular disease, including threatened foot amputations, gangrene, atherosclerosis, and hypertension.79
