Because diabetes compromises immune system functioning, cellulitis in the lower legs can be problematic for diabetics who experience frequent and slow-healing bacterial infections. Cellulitis is severe inflammation of the skin, specifically the connective tissue, which affects the subcutaneous and external skin layers. While cellulitis can occur on skin covering any part of the body, it most frequently inflames the lower legs, feet and the face.
Causes of cellulitis in the lower legs emerge from bacterial infections of the skin where previous burns, insect bites, animal bites, blisters or any other wound has occurred. Cellulitis has also been known to appear where intravenous openings were made but had been fully healed for some time. Because cellulitis can attack old wounds, a break in the skin does not need to be visible for vulnerable areas to be compromised by bacterial cellulitis.
Although Staphylococcus and Group A Streptococcus are microorganisms normally found on the skin, it is these two types of bacteria that induce cellulitis. While they exist without harming us on the outside of our skin, once they enter through an open wound or even a tiny crack in the skin, an infection can develop, causing cellulitis.
Diabetics experience poor control of glucose and insulin levels which permits rapid proliferation of bacteria infecting tissues with cellulitis. Bacteria thrive in glucose-rich environments, especially when there are insufficient amounts of disease-fighting white blood cells. In addition to being prone to cellulitis in the legs, diabetics are also vulnerable to foot cellulitis and foot ulcers. This is due to the prevalence of impaired, lower-body circulation in many people with diabetes.
Symptoms of a cellulitis infection include:
- Swelling and pain in the infected area
- Redness, rash and tenderness
- Chills, sweating and fever if the infection has spread beyond the initial site
- Swelling of lymph nodes
- Red streaks extending up or down the leg
- Clear or yellow drainage from the infection
- Aching muscles
Initially, someone affected by cellulitis may think it is a case of shingles or dermatitis because the symptoms are similar, especially the redness, tenderness and swelling aspect of the condition. However, when a diabetic suffers from these symptoms, it is recommended they visit their physician to rule out the possibility of cellulitis.
A doctor might also order blood tests, ultrasounds and cultures to make sure it is not a more severe medical condition called deep vein thrombosis, which can be dangerous to diabetics. A diagnosis of deep vein thrombosis means a blood clot exists deep in the leg’s vein. These clots have the ability to travel through veins until they reach the brain, where strokes can occur if the clot isn’t dissolved in time.
Treatment for Cellulitis
- Debriding the area to clear away any dead tissue
- Intravenous or oral administration of antibiotics, depending on the severity of the infection
- Pain relief medication if needed
- Keeping the infected leg elevated
Due to impaired immune system functioning in diabetics, cellulitis often recurs. However, recurrence is more common in those who suffer from circulatory issues or problems with their lymphatic system which further inhibits the ability of white blood cells to fight the infection. If a diabetic who does not suffer from complications develops cellulitis, they generally only need a regimen of antibiotics to eliminate the infection and prevent recurrence.
Reducing the risk of developing cellulitis involves maintaining personal hygiene, avoid walking barefoot or wearing shorts in areas (dense woods) where the skin could be cut or scratched and keeping skin moisturized so excessive dryness does not cause the skin to crack or split. It also involves taking your diabetic medication as prescribed without fail. Pill Pal can help remind you to take your medication when needed so that you avoid suffering the consequences of unmanaged diabetes.