The Terrible Triad of Diabetes (Bad Things Come in Threes)

Did you hear about poor uncle Steve? He cut himself while trimming his toe nails. So you might ask: “What’s the big deal“? Steve wasn’t concerned. In fact, it didn’t hurt at all, so why would he worry? Even though the cut didn’t heal in the usual time, he didn’t give it a second thought. That changed when he developed an infection, and he ended up losing his leg.

Why did Steve suffer such a fate? What did he do wrong?

Could it be related to his diet, which for many years had consisted of fast food, frozen food, and phoney food? (Just what is cheez-whiz?) Certainly, his lifestyle was an important part of the process that lead to his clogged blood vessels, his heart disease, and diabetes. He didn’t like exercising, and had never been interested in sports. Steve wasn’t in very good shape, and he knew it. In addition, he had the family history: his mother developed diabetes years ago, and took so many medicines, it made Steve’s head spin. Perhaps the final piece of the puzzle was the fact that he hated going to doctors.

As you may have guessed, Steve suffered from diabetes, which prevented him from feeling the small cut that he made. Naturally, diabetics with nerve problems (a condition called neuropathy) are instructed not to perform this “simple“ task, for this very reason. Bacteria gained entrance to his body through the small opening in his toe, causing an infection to develop. The infection was able to flourish, because of the immune system problems that befall many of those afflicted with diabetes. This particular facet of diabetes, the impaired immune system, is called immunopathy. Specifically, some of the mechanisms the body uses to fight off bacteria fail to work properly, and quite literally, their defenses are down.

The amputation that Steve suffered was thus the result of “The Terrible Triad“; the three organsystems in the body that, when impaired by diabetes, are far more dangerous collectively than any of them singly. Two of them have been mentioned, the nerve problems and the immune system problems, that are two parts of this threesome.

The third, and perhaps most dangerous, component is the blood flow problems. This does not refer to clotting problems, but instead, to clogging problems, clogs that grow inside the arteries of the legs, causing more numerous and serious blockages in those afflicted with this terrible disease. The effects can be catastrophic.

Any living tissue, derived of blood, will die. It is a basic, immutable law in medicine and wound healing. Prior to the skin reaching that point (which is known as gangrene!), it becomes stiff,discolored, shiny. An additional consequence? The skin becomes more fragile, more easily damaged, and so, a poorer barrier to bacteria.

If Steve had bothered to get educated about his health, and especially about his diabetes, the amputation could have been prevented. He would have learned how important it was to check his feet regularly. If he had, he would have seen the cut, and would know he needed to go to a specialist in diabetic foot medicine, to get the specialized care required.

Major amputations of the foot or leg occur far too frequently in our society. Statistics tell us, quite clearly, it is usually due to diabetes and its devastating effects on blood flow, nerve function, and the effectiveness of our bacterial defense system. The famous three pathologies know as the “Terrible Triad“!