Diabetic foot wounds and male gender

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Hello all,

can anyone tell me of any research that points to males being less able to heal diabetic foot ulcerations? I read Ostomy Wound Management and there was an article claiming that males had a lower healing rate than females. Is this correct and if so, can anyone tell me if we know why?

curious

 

i believe males are more likely to be neuropathic than females..herein may lie part of the answer???

 

why are they more likely to be neuropathic? is there any research that points to this? is it not that testosterone has an inhibitory effect on wound healing? does anyone else have any feedback on this one?

too many questions and not enough answers...:bash:

 

Hiya

I know it has been cited lots of times at conferences/training sessions i have attended. You are more likely to become db being male also..I must seek out the literature but heres one i found from a quick google search

http://docs.google.com/gview?a=v&q=...les more likely to be neuropathic&hl=en&gl=au

BG control is fundamental to wound healing...maybe it is a compliance issue in males or maybe its just harder to control BGs being male due to other horminal influences..

Combine the crap glucose control with neuropathy and you have a recipe for a non healing wound

B
X

 

hi

seems to me that the different surveys defined neuropathy differently, so it is difficult to compare the studies mentioned. The National Health Survey did not find a difference in men and women prevalence of neuropathy. The San Luis valley did find that diabetes was more prevalent in men!! In any case it seems that age and weight and socioeconomic status were more powerful predictors of neuropathy in the diabetic populations than sex alone. However you are right in saying that neuropathy was more prevalent in men (san luis valley study)

Having said that, with the little experience I have (being a student still), that almost all recurring ulcerations are in men. to me it seems that the compliance point you made has to be one of the most important areas for further exploration??

it seems to me that it is a very complex problem that is still not understood fully yet???



thanks again

 

There is plenty on this; you just going to have to do a literature search for it.

I do recall one publication that showed different serum levels of nitric acid (a vasodilator) between males and females with diabetic foot ulcers --- ie a physiological difference.

There is also a considerable body of literature of difference between males and females with diabetes in their health seeking behaviours --- ie a behavioural difference (eg females are more likely to go to dr for intervention before males do)

 

Length of nerve fibres may also be relevant

 

H,

good topic. I have always thought that the taller you were the more likely to develop neuropathy. That being said I never see tall women with neuropathy only men so perhaps men tend to ignore health issue more than women.
great study to do

 

wow, thanks for the feed back

According to uk figures, in the age group between 35-54 there are almost twice as many men diagnosed with diabetes. Not surprisingly there will be many more men with chronic foot ulcers.

maybe i am flogging a dead horse here?

 

it would be very interesting to do a study that reported on people's health behaviours- if it was accurate enough you could attribute the any differences to gender. has this type of study been done before? you would need a lot of resources for one.

 

yea exactly malaligned, great study to do. i am pretty sure there is a gender-behavioural issue here. men are simply not taught to 'take care of wounds' in society. maybe this is transferred to themselves when they get an ulcer. they expect the 'mother figure' to take care of it?!! ie. the nurse/podiatrist etc.

 

I vaguely recall a qualitative type study from >10yrs ago that looked differernt hypothetical scenarios put to males and females with diabetes. If I recall correctly, the males where less likely than the females to seek immediate help if a "pre-ulcer" developed. Males are more likely to wait a day or two to see what happens. This is consistent with the health seeking behaviours reported in the literature for males and females.

 

'Males are more likely to wait a day or two to see what happens. This is consistent with the health seeking behaviours reported in the literature for males and females.'

do you think that this trend is likely to be consistent throughout the 'lifetime' of a diabetic male?

i read somewhere that some forms of diabetic 'education' worked - especially with patients who'd had an ulcer; that scare tactics ie. showing pictures of amputated feet and large chronic infected ulcers and such like, coupled with 'reminders' in the shape of flash cards increased health behaviour??