Diabetes Care

Diabetes is a serious disease that affects millions of Americans, and that number is going to astronomically grow as the baby boomer generation ages further. Complications associated with diabetes can be devastating, and can lead to organ failure and even death. Foot-related complications in particular are very common in diabetes, and unfortunately cause the majority of leg amputations performed by surgeons. Comprehensive care by a podiatrist can identify foot problems early before they lead to leg loss, and in many cases can prevent those problems in the first place. This article will discuss the ways a podiatrist can protect diabetic feet, and ultimately save a diabetic’s limb and life.

Diabetes is a disease in which glucose, the body’s main source of ‘fuel’, is not properly absorbed into the body’s tissues and remains stuck in the bloodstream. Glucose is a type of ‘sugar’ derived from the body’s digestion of carbohydrates (grains, breads, pastas, sugary food, fruits, starches, and dairy) The body needs a hormone called insulin, which is produced in the pancreas, to coax the glucose into body tissue to fuel it. Some diabetics are born with or develop at a young age an inability to produce insulin, resulting in type 1 diabetes. The majority of diabetics develop their disease as they become much older, and the ability of insulin to coax glucose into tissue wanes due to a sort of resistance to or an ineffectiveness of the action of insulin. This is called type 2 diabetes. Diabetes can also develop from high dose steroid use, during pregnancy (where it is temporary), or after pancreas disease or certain infections. The high concentration of glucose in the blood that remains out of the body tissue in diabetes can cause damage to parts all over the body. Organs and tissue that slowly are damaged by high concentrations of glucose stuck in the blood include the heart, the kidneys, blood vessels, the brain, the nerve tissue, skin, and the immune and injury repair cells. The higher the concentration of glucose in the blood, and the longer this glucose is present in the blood in an elevated state, the more damage will occur. Death can occur with severe levels of glucose in the blood stream, although this is not the case in most diabetics. Most diabetics who do not control their blood glucose well develop tissue damage over a long period of time, and serious disease, organ failure, and the potential for leg loss does eventually arrive, although not right away. Continue Reading

People with diabetes often suffer from foot ulceration. It’s even more of a problem if the diabetic has peripheral neuropathy and/or peripheral vascular disease.

Pain aside, what’s worse is that some people with these ulcers may need to have a partial or total amputation of the affected limb.

What’s the result?

• Physical disability
• Loss of quality of life
• Losing income

In addition, NHS healthcare costs go up.

So, what to do about foot care education for diabetics?

We think health professionals can help by educating diabetic people on how to prevent them developing ulcers in the first place.

Why? It seems common sense to us but, in addition, there was a systematic review to examine patient education programmes designed to prevent diabetic foot ulcers. Read on…

The Study About Diabetic Foot Care Education In Brief

• There were 11 randomised controlled trials
• In all, they studied more than two and a half thousand adults who had type 1 or type 2 diabetes
• They compared the programmes with usual care, bespoke care and no intervention

The study evaluated educational programmes that were designed with reducing foot ulcer incidence in mind – they also looked at the incidence of recurrence of ulcers, amputation, callous development, fungal infection, and the number of hospital admissions (and the duration of stays). Continue Reading

Diabetes management and team approach, when combined, go a long way in providing the best possible care for the patients. So when I read the latest news on the early team approach being the best medicine, I dove right into it. I am not a stranger to this concept as I have always used this in my practice.

Integrating a team of specialists including a diabetes educator, a dietitian, cardiologist, nephrologist and endocrinologist is the way to go to lower the risk of complications. It can also lower the cost for the health care system. So does an online survey of physicians found out.

About 44% of the physicians reported that 50% of their patients developed one of the complications including nerve pain, cardiovascular disease, stroke, limb amputation, blindness and kidney disease. They said that most patients are not aware of these complications, especially the kidney disease.

What is not realized is that most people diagnosed with type 2 diabetes already have some form of impairment in the kidney. In order for the patients to know of this complication is to require yearly testing for those at the earliest stage of type 2 diabetes including a microalbumin urine test.

Those on the latter stage of type 2 diabetes should have blood testing of the kidney function. Knowing the impairment can lead to interventions to prevent further damage to the kidney and other serious type 2 complications like heart disease.

The physicians revealed in the survey that patients do not adhere to lifestyle modifications as well as following the prescription. In this case, the intervention of nutritionist or dietitians can help patients get back on track. About 63% of the participants agreed the members of the team can help them. Continue Reading