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Diabetes: A common comorbidity among pressure ulcer patients

Regardless of the care setting a patient is admitted to, any length of stay must be accompanied by a risk assessment for preventing pressure ulcers. This health evaluation includes inspection of the skin, review of any nutrient deficiencies and an understanding of not only the most pressing medical status, but also of any ongoing and underlying comorbidities.

Previous studies have suggested that certain comorbidities increase the likelihood that a patient will develop a pressure ulcer. One team of scientists from Tokyo Medical University decided to review all English-language literature on the subject and concluded that, while various diseases may predispose patients to pressure ulcers, diabetes is the most prominent comorbidity.

Studies 'underscore the importance of recognizing patient comorbidities'

According to the authors of the study, which was published in the International Journal of Clinical Dermatology & Research, previous research papers linked the occurrence of pressure ulcers to various health conditions, such as spinal cord injuries, hip fractures, cardiovascular disease, diabetes and more. To determine which ones had the strongest ties to pressure ulcer rates, the authors conducted a literature review and divided all the studies they found into five categories based on care setting: nursing homes, hospitals, rehabilitation centers, home care and the perioperative setting.

Results showed that study design, patient background, sample size and risk factor variables were different in each study. Even within the five setting categories, there was a large dispersion of research findings. However, there were still notable trends.

"In summary, the findings of previous studies investigating risk factors for [pressure ulcer] development underscore the importance of recognizing patient comorbidities in order to prevent [pressure ulcers]," the researchers wrote. "Despite the large dispersion seen between the study results, diabetes mellitus, cardiac disease, renal disease and respiratory disease were found to be risk factors across a variety of settings."

The association between pressure ulcers and diabetes in particular seemed to be strong. At least half of the studies reviewed in all of the care settings indicated that diabetes was a risk factor for pressure injuries. Given how ubiquitous this condition is, it is important for health care providers to be aware of this in their assessment of patients. According to the National Institute of Diabetes and Digestive and Kidney Diseases, an estimated 25.8 million individuals in the U.S. are living with diabetes, which accounts for 8.3 percent of the nation's population. However, about 7 million of these patients are unaware that they have this condition or have never been diagnosed.