Diabetic Necrosis: Definition, Symptoms, and Anxiety it Causes

Diabetic necrosis is the death of tissues in the body, and it causes serious consequences that can sometimes include the amputation of limbs, fingers, or toes. This necrosis definition alone can cause anxiety ("Diabetes and Anxiety: There’s Plenty to Be Anxious About"). While diabetic necrosis is frightening, you do have some control over diabetes, tissue death and anxiety.

What is Necrosis?

Necrosis is closely related to gangrene. Like necrosis, gangrene is the death of tissue or organs. The two terms are often used interchangeably, but they’re not quite the same. What’s necrosis? Very simply put, necrosis is a process while gangrene is an event, the result. When you see an open, oozing sore or dry, shriveled skin, you are seeing gangrene. The process of necrosis involves:

• Damages at the cellular level
• Large- or small tissue or organ damage
• Biochemical changes that lead to tissue injury
• Inflammation in the body that furthers damage
• Scarring that also aggravates and leads to more damage in the area
• Tissue death and loss

Here we’re looking at the big picture, so we’ll use the term “necrosis.”

What Causes Diabetic Necrosis?

Diabetes is a disease that involves problems with blood sugar levels. Under normal circumstances, the glucose, or sugar, created in the process of digestion is carried in the bloodstream throughout the body and is delivered to cells. In a healthy body, insulin greets glucose and escorts it into the cells. In diabetes, there is a problem with insulin, so glucose remains in the bloodstream and builds. It is this high blood sugar (hyperglycemia) that can cause necrosis.

Necrosis from diabetes is because of high blood sugar. Hyperglycemia damages nerves and blood vessels and reduces blood flow. These conditions can cause a host of health problems, including necrosis.

This example illustrates how diabetic necrosis happens. Because feet are a very common location of tissue death, this example uses the foot. Similar processes occur in other areas of the body.

• Because of hyperglycemia, nerves are damaged (diabetic neuropathy)
• Nerve damage causes loss of feeling
• With no feeling, rocks in shoes, shoes rubbing skin, and nicks and cuts go unnoticed and thus untreated
• Lack of treatment can cause infection
• Infection quickly worsens because a lack of adequate blood flow inhibits healing
• The necrotic process has begun on all levels

Necrosis Symptoms

Necrosis from diabetes produces specific symptoms. When necrosis is internal, affecting muscles or organs, common symptoms are

• Swelling
• Pain that can be intense
• Persistent low-grade fever
• Feeling generally unwell
• Drowsiness
• Lethargy
• Nausea

Necrosis symptoms that occur when damage is external, on the skin, include:

• Extreme skin discoloration (such as brown, bronze, blue, purple, red, black)
• A distinct line between the healthy skin and the dying skin
• Severe pain, then numbness
• Foul-smelling pus leaking from a sore
• Cold skin
• Thin, shiny skin
• Skin that crackles when touched
• Blisters

Any area of the body, internal and external, can be affected by this deadly process. Necrosis of the skin is common in diabetes. Diabetic necrosis also frequently affects a foot or both feet. Necrosis on a toe or toes is also a widespread problem.

There is another important, and very common, effect of necrosis: anxiety.

Dealing with Anxiety Caused by Necrosis in Diabetes

Once the process of necrosis begins, it can’t be reversed, and it can’t be cured. Anxiety in necrosis is intense and very specific. It is fear-based and future-oriented. This is merely a sampling of the anxious thoughts associated with necrosis:

• What if I lose a part of myself because of amputation?
• Will I always be able to (fill in the blank with any activity, even small ones like walking to get the mail)?
• What if I develop necrosis and it keeps spreading?
• Will my family still want to be around me, or will I be too much of a burden?
• Will I die?

The anxiety that comes with necrosis can be debilitating. Given that nerve damage can prevent people from noticing little damage that can lead to infection and tissue death, people often feel extreme anxiety and even panic about developing something so serious that they can’t control.

As unlikely as it may seem at first, you do indeed have quite a bit of control over both diabetes and anxiety. You can act to prevent the development of necrosis:

• Manage your blood sugar to keep it within normal range.
• Maintain a healthy diet.
• Lose weight if necessary.
• Stop smoking if you smoke.
• Exercise daily.
• Check your body for cuts and sores (especially your feet).
• Always wear shoes and socks.
• Maintain blood flow to your lower extremities (elevate legs/feet, wear loose-fitting socks)
• Attend regular check-ups with your doctor and anyone else on your care team

By taking charge of your health and your life, you reduce your chances of developing necrosis, and this control is an empowering way to lower anxiety. Necrosis from diabetes isn’t inevitable.

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