A patient in his 60s was diagnosed with type 2 diabetes after stepping on a sea urchin.
- A man in his sixties was taken to hospital because he stepped on a sea urchin.
- The thorns were removed, the foot disinfected and he was able to leave.
- 17 days later, he was admitted to the emergency room for diabetic foot syndrome.
It’s an atypical way to be diagnosed: a man in his sixties discovered his type 2 diabetes after stepping on a sea urchin, according to a study published on Univadis.
Patient returns to emergency room 17 days after stepping on sea urchin
The beginning of the story is common: a German tourist, on vacation in Zanzibar, steps on a sea urchin. He goes to the hospital to have medical professionals remove the thorns from his foot and disinfect it. He receives antibiotics and, as he does not have a fever, he can leave.
Seventeen days later, the same patient was admitted urgently because his right foot was red, swollen and three of his toes were necrotic. Despite all this, he had no pain… He was immediately operated on: his three toes were amputated.
With all these symptoms, how is it possible that the patient did not feel pain? Doctors then make the diagnosis: diabetic foot syndrome with acute neuropathy. Until this moment, the patient was unaware that he had type 2 diabetes.
“The painless evolution of the sixty-year-old’s gangrene proves that he must have developed significant diabetic neuropathy from the phase of prediabetes or undiagnosed diabetes without him realizing it, can we read on Univadis. Diabetic neuropathy is, according to‘Health Insurance, damage to the sensory nerves due to hyperglycemia – high blood glucose level – chronic. So he didn’t feel any pain.
In their study, the authors talk about diabetic foot syndrome on vacation, which “describes foot injuries typically occurring during vacations in people with long-known type 2 diabetes”, explain the authors.
As the patient was unaware of his diabetes, once the thorns were removed, he continued to enjoy his vacation. He therefore stressed his feet more than usual with significant steps and/or unusual shoes, which could have delayed healing and encouraged infection, without him feeling any pain.
Type 2 diabetes, a silent disease that delays diagnosis
Type 2 diabetes represents 90% of cases of diabetes in France, according to the National Institute of Health and Medical Research (Inserm). For a long time, the disease can remain silent, that is, not cause any symptoms. It is estimated that 20 to 30% of adults with diabetes are undiagnosed.
This is also what the authors of this study note. “Every week several patients with late diabetic complications (diabetic foot syndrome, renal failure, etc.) [sont découverts dans leur service]in whom type 2 diabetes was not previously known”, they indicate.
