Fournier's Gangrene: A Diabetes Complication

I'm not surprised if you've never heard of Fournier's gangrene (FG). It's a rare complication of diabetes (noted in less than 0.1 percent of hospitalizations).¹

FG is a type of necrotizing fasciitis, otherwise known as a "flesh-eating disease." It happens on or around the genitals or the area between your genitals and rectum.^1-3

Learn about the symptoms

An infection like FG can destroy your body's tissues, including muscles, blood vessels, and nerves. It is considered a life-threatening medical emergency. Here are some things to know about FG risk factors, signs, and what to do if you develop symptoms.

What are the risk factors of Fournier's gangrene?

Up to 70 percent of people who develop FG have diabetes.⁴

People are also at increased risk if they have health conditions that decrease the immune system response, such as:^1-3

• HIV
• Chronic alcohol use
• Heart conditions
• Kidney conditions

Men are at higher risk for developing FG than women. Also, malnutrition and lack of access to community resources like stable jobs, safe housing, secure finances, and healthcare can increase your risk.^1-3

Certain medicines increase risk

One class of diabetes medications increases the risk of FG. These are the sodium-glucose cotransporter-2 (SGLT2) inhibitors, such as Invokana, Jardiance, Farxiga, and Steglatro.⁴

While many people use these medications safely, it's essential to know how to care for your body while taking these medications. Take extra care with the following actions:^1-3

• Cleaning your genital area regularly
• Using baby wipes after urinating to clean your skin
• Making sure the skin stays clean and dry

How to lower your risk

There are some things you can do to help lower the risk of FG:^1-4

• Keep your genitals and the area between your genitals and rectum clean and dry.
• Use clean razors when shaving.
• Check areas daily for redness, swelling, pain, or crackling sounds when touching the skin.
• Stop using tobacco products or smoking.

Remember, diabetes can affect nerve endings (neuropathy) and your ability to feel pain, so looking at these areas every day is very important.⁴

What are the symptoms of Fournier's gangrene?

People often report pain in or around the genitals as one of the first signs of FG. Other common signs are redness or swelling, a fever of at least 100.4 degrees Fahrenheit, or not feeling well overall.^1-3

A popping or crackling sound of the skin in that area (called crepitus) can happen. You also may notice changes in your urinary patterns.^1-3

In addition, you may notice a strong smell in your groin, fever, chills, low energy/exhaustion, or nausea and vomiting.^1-3

If FG goes untreated, it can lead to a blood infection (sepsis), organ failure, and death.^1-3

How is Fournier's gangrene treated?

While redness, swelling, or pain may not seem like a big deal, they are in the case of FG. Time can make all the difference, with hours being the difference between life and death. With any signs or symptoms of FG, you should go directly to the emergency room for evaluation. Don't wait.

Treatment of FG usually requires surgery and antibiotics, but may also include blood thinners or hyperbaric chamber treatments. Removing the infected tissue is the best way to stop the breakdown of more of your body.⁴

Keep blood sugar levels stable

In my experience as a Certified Diabetes Care and Education Specialist, the men I've seen develop FG often struggled with very high blood sugars. In general, keeping your blood sugar at healthy levels can play an essential role in lowering infection risks and recovering from infections.

Fournier's gangrene is very rare. Less than 0.01 percent of men develop FG.⁴

However, it is a medical emergency. Knowing the signs and symptoms of FG may save your life or the life of someone you know.