Ask the Diabetes Educator Archive

9/21/04

Q:
Can a severe trauma with multiple surgeries due to chronic osteomyelitis be the cause of, or trigger diabetes?

I am a 44 year old male and am insulin dependent. I was in the Army when I was ran over on my motorcycle. I had open fractures of my tibia and femur and fibula. I got the osteomyelitis secondary to the trauma. I underwent 20 plus surgeries to save my leg. I have had a functional loss of use of my leg for several years now. As time went by, I developed type II diabetes. It progressed until I was on insulin. I could not exercise for the longest time because of the severe pain I would endure. But, about two years ago, my VA doctor prescribed Vicodin for me for long term use. I have exercised every day for 1.5 hours since then and have lost 26 pounds and brought my A1C from the 8% range down to 6.7%. All my lab work is in the normal range now. I went from almost 100 units of 70/30 a day down to 25 units.

I believe if I could have a normal leg again, I could become diabetes free. Could my disability have caused the diabetes? Could it have contributed to me getting diabetes?

A:

Trauma and stress may always be considered as a possible trigger for developing diabetes, particularly when one already has the genetic disposition for it. What appears to be working for you now is that because you are able to exercise, your numbers are reflecting positive changes in blood sugars.

Can I assume that you have a professional who has worked closely with you on matching blood sugars with food intake? It may be that you don't require the type of insulin you are on, one that may not be controlling blood sugars as artfully as a program such as Lantus and adding Humalog if needed. It may be that you are only insulin-requiring, rather than "dependent". A C-Peptide test may be an indicator here of your insulin production. Certainly, having an uninterrupted circulatory system facilitates better metabolism and glucose control, but does not make better management "impossible", as you are proving. Get assistance if you need it with dietary management, and keep up your good lifestyle changes!



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