Vascular system
Diabetics can have poor tissue-blood perfusion in their extremities. This affects the peripheral vasculature and nerve supply. This has consequent atrophic changes. The skin becomes fragile and loses its ability to withstand mechanical stress, and thermal and chemical trauma. An intact microcirculation, which can be impaired in a diabetic, is essential for tissue nutrition, metabolite removal, the inflammation process, and for temperature control. Therefore this can dispose the diabetic to ulceration and possibility of further infection i.e. cellulitis
Nervous system
Diabetics can have sensory neuropathy which results in a decreased sensation. If an injury has occurred, the lesion may not be felt by the diabetic. Therefore, a developing ulcer may not be noticed, putting the diabetic at risk of a secondary cellulitis infection.
Muscular system
Muscle neuropathy can develop in the diabetic which leads to the wasting of intrinsic muscles. This can result in altered foot function and affect the gait of the person. This can lead to formation of calluses on the feet from standing on one area for too long, and due to the neuropathy, not noticing that too much pressure is being put on that area. This can result in the formation of an ulcer, once again, allowing a portal to bacterial invasion.
Functional abnormalities
Due to micro vascular disease in the extremities, and therefore the decreased ability of the immune system to perform the inflammation process, when bacteria do invade, there is less chance to fight them off. This increases the chance of bacterial infection in cellulitis.
Raised blood sugar levels and reduced insulin– decrease the bactericidal properties of granulocytes (neutrophils, eosinophils, basophils) – decreased immunity
Blood can be thicker in diabetics – harder to get to infection site.
Autonomic neuropathy, a microvascular disease manifestation found in diabetics – this can affect how much someone sweats. Decreased...