Foot care is especially important if you have diabetes. Diabetes can impair blood flow to your feet and cause nerve damage. Without proper attention and care, a small injury can develop into an open sore (ulcer) that can be difficult to treat. Sometimes amputation is necessary if an infection severely damages the tissue and bone.
The good news is that with proper diabetes management and careful foot care, amputation may be preventable. Here's what you need to know about the link between amputation and diabetes — and how to keep your feet healthy.
Why does diabetes pose a risk of amputation?
Diabetes can cause two potentially dangerous threats to your feet.
* Nerve damage (diabetic neuropathy). When the network of nerves in your feet is damaged the sensation of pain in your feet is reduced. Because of this, you can develop a blister or cut your foot without realizing it.
* Reduced blood flow. Diabetes can also narrow your arteries, reducing blood flow to your feet. With less blood to nourish tissues in your feet, it's harder for sores to heal. An unnoticed cut or sore hidden beneath your socks and shoes can quickly develop into a larger problem.
Left untreated, a minor foot injury could become a serious infection — even leading to tissue death (gangrene). Severe damage might require toe, foot or even leg amputation.
~ MayoClinic.com ~
Wednesday, October 14, 2009
The diabetic foot: amputations are preventable
People with diabetes are at risk of nerve damage (neuropathy) and problems with the blood supply to their feet (ischaemia). Both neuropathy and ischaemia can lead to foot ulcers and slow-healing wounds which, if they get infected, may result in amputation.
In 2000 the International Diabetes Federation endorsed the International Working on the Diabetic Foot as a Consultative Section on the Diabetic Foot. Together the organizations established goals for the future of diabetic foot care worldwide.
Goals
* to inform people of the extent of diabetic foot problems worldwide
* to raise awareness of the diabetic foot among those at risk and those in a position to take action
* to persuade healthcare decision makers that action is both possible and affordable
* to warn healthcare decision makers of the consequences of not taking action
* to inform people with diabetes of the measures they can take to prevent foot complications
Diabetes is a serious chronic disease. In 2003 the global prevalence of diabetes was estimated at 194 million. This figure is predicted to reach 333 million by 2025 as a consequence of longer life expectancy, sedentary lifestyle and changing dietary patterns. This rise is likely to bring a proportional increase in the numbers of people with diabetes complications, including problems of the foot.
Most amputations begin with a foot ulcer
Diabetic foot ulcers as a result of neuropathy or ischaemia are common. In developed countries, up to five per cent of people with diabetes have foot ulcers, and one in every six people with diabetes will have an ulcer during their lifetime. Foot problems are the most common cause of admission to hospital for people with diabetes. In developing countries, foot problems related to diabetes are thought to be even more common. Without action, global amputations rates will continue to rise.
Every 30 seconds a leg is lost to diabetes somewhere in the world
Extensive epidemiological surveys have indicated that between 40% and 70% of all lower extremity amputations are related to diabetes. This means that every 30 seconds a lower limb is lost to diabetes. The vast majority (85%) of all diabetes-related amputations are preceded by foot ulcers.
For most people who have lost a leg, life will never return to normal. Amputation may involve life-long dependence upon the help of others, inability to work and much misery. Aggressive management of the diabetic foot can prevent amputations in most cases. Even when amputation takes place, the remaining leg and the person’s life can be saved by good follow-up care from a multidisciplinary foot team.
In developed countries diabetic foot care accounts for up to 20% of total healthcare resources available for diabetes. In developing countries, it has been estimated that foot problems may account for as much as 40% of the resources available. In western countries, the economic cost of a diabetic foot ulcer is thought to be between US$7,000 and US$10,000. Where healing is complicated and amputation required, this cost may increase to as much as US$65,000 per person.
Up to 85% of amputations can be prevented
In most cases, however, diabetic foot ulcers and amputations can be prevented. Researchers have established that between 49% and 85% of all amputations can be prevented. It is imperative, therefore, that healthcare professionals, policymakers and diabetes representative organizations undertake concerted action to ensure that diabetic foot care is structured as effectively as local resources will allow. This will facilitate improvements in foot care for people with diabetes throughout the world and bring about a reduction in diabetic-foot-related morbidity and mortality.
Significant reductions in amputations can be achieved by well-organized diabetic foot care teams, good diabetes control and well-informed self care
There is strong evidence to indicate that foot care is best delivered when it is provided by a multidisciplinary team. This should closely involve the person with diabetes and his or her family, along with healthcare professionals from different specialties. Ideally the team will include a physician, a nurse, a specialist educator, a podiatrist, a surgeon, an orthotist (shoemaker) and an administrator. The podiatrist is a key member of the multidisciplinary diabetic foot team. At present there is a lack of trained podiatrists working in diabetic foot care. Mandatory minimal skills and equipment for those offering a podiatry service should be controlled to ensure that people with diabetes are not put at increased risk by unregulated, unqualified and poorly equipped practitioners.
IDF’s position is that management in the prevention and treatment of diabetic foot problems includes the following:
* Annual inspection of the foot
* Identification of the foot at risk
* Education of people with diabetes and healthcare professionals
* Appropriate foot wear
* Rapid treatment of all foot problems
Only through a multidisciplinary approach addressing the diversity of possible foot problems in people with diabetes can the desired reduction in amputation rates be achieved.
Conclusion
It is now time to take appropriate action to ensure that people with diabetes everywhere receive the quality of care that they deserve. It is hoped that global awareness of diabetes and its complications will be raised and that the necessary attention will be paid to the need for improved foot care for people with diabetes throughout the world.
IDF recommends that every individual with diabetes receive the best possible foot care. At the organizational level, diabetic foot care should be structured in such a way as to optimize treatment and prevention possibilities. For this to be feasible all parties involved (i.e. healthcare providers, policymakers and patient organizations) should recognize the need for combined action.
~ International Diabetes Federation ~
In 2000 the International Diabetes Federation endorsed the International Working on the Diabetic Foot as a Consultative Section on the Diabetic Foot. Together the organizations established goals for the future of diabetic foot care worldwide.
Goals
* to inform people of the extent of diabetic foot problems worldwide
* to raise awareness of the diabetic foot among those at risk and those in a position to take action
* to persuade healthcare decision makers that action is both possible and affordable
* to warn healthcare decision makers of the consequences of not taking action
* to inform people with diabetes of the measures they can take to prevent foot complications
Diabetes is a serious chronic disease. In 2003 the global prevalence of diabetes was estimated at 194 million. This figure is predicted to reach 333 million by 2025 as a consequence of longer life expectancy, sedentary lifestyle and changing dietary patterns. This rise is likely to bring a proportional increase in the numbers of people with diabetes complications, including problems of the foot.
Most amputations begin with a foot ulcer
Diabetic foot ulcers as a result of neuropathy or ischaemia are common. In developed countries, up to five per cent of people with diabetes have foot ulcers, and one in every six people with diabetes will have an ulcer during their lifetime. Foot problems are the most common cause of admission to hospital for people with diabetes. In developing countries, foot problems related to diabetes are thought to be even more common. Without action, global amputations rates will continue to rise.
Every 30 seconds a leg is lost to diabetes somewhere in the world
Extensive epidemiological surveys have indicated that between 40% and 70% of all lower extremity amputations are related to diabetes. This means that every 30 seconds a lower limb is lost to diabetes. The vast majority (85%) of all diabetes-related amputations are preceded by foot ulcers.
For most people who have lost a leg, life will never return to normal. Amputation may involve life-long dependence upon the help of others, inability to work and much misery. Aggressive management of the diabetic foot can prevent amputations in most cases. Even when amputation takes place, the remaining leg and the person’s life can be saved by good follow-up care from a multidisciplinary foot team.
In developed countries diabetic foot care accounts for up to 20% of total healthcare resources available for diabetes. In developing countries, it has been estimated that foot problems may account for as much as 40% of the resources available. In western countries, the economic cost of a diabetic foot ulcer is thought to be between US$7,000 and US$10,000. Where healing is complicated and amputation required, this cost may increase to as much as US$65,000 per person.
Up to 85% of amputations can be prevented
In most cases, however, diabetic foot ulcers and amputations can be prevented. Researchers have established that between 49% and 85% of all amputations can be prevented. It is imperative, therefore, that healthcare professionals, policymakers and diabetes representative organizations undertake concerted action to ensure that diabetic foot care is structured as effectively as local resources will allow. This will facilitate improvements in foot care for people with diabetes throughout the world and bring about a reduction in diabetic-foot-related morbidity and mortality.
Significant reductions in amputations can be achieved by well-organized diabetic foot care teams, good diabetes control and well-informed self care
There is strong evidence to indicate that foot care is best delivered when it is provided by a multidisciplinary team. This should closely involve the person with diabetes and his or her family, along with healthcare professionals from different specialties. Ideally the team will include a physician, a nurse, a specialist educator, a podiatrist, a surgeon, an orthotist (shoemaker) and an administrator. The podiatrist is a key member of the multidisciplinary diabetic foot team. At present there is a lack of trained podiatrists working in diabetic foot care. Mandatory minimal skills and equipment for those offering a podiatry service should be controlled to ensure that people with diabetes are not put at increased risk by unregulated, unqualified and poorly equipped practitioners.
IDF’s position is that management in the prevention and treatment of diabetic foot problems includes the following:
* Annual inspection of the foot
* Identification of the foot at risk
* Education of people with diabetes and healthcare professionals
* Appropriate foot wear
* Rapid treatment of all foot problems
Only through a multidisciplinary approach addressing the diversity of possible foot problems in people with diabetes can the desired reduction in amputation rates be achieved.
Conclusion
It is now time to take appropriate action to ensure that people with diabetes everywhere receive the quality of care that they deserve. It is hoped that global awareness of diabetes and its complications will be raised and that the necessary attention will be paid to the need for improved foot care for people with diabetes throughout the world.
IDF recommends that every individual with diabetes receive the best possible foot care. At the organizational level, diabetic foot care should be structured in such a way as to optimize treatment and prevention possibilities. For this to be feasible all parties involved (i.e. healthcare providers, policymakers and patient organizations) should recognize the need for combined action.
~ International Diabetes Federation ~
How Do I Know if I Have Leg Ischemia?
Ischemia of the lower extremities will manifest itself in many different ways ranging from asymptomatic (simply the presence of a blockage) to gangrene of the leg or a part of it. Quite often a patient will have an asymptomatic blockage (one that they do not know is there) that is manifested simply by an absent pulse in the foot, behind the knee or in the groin or an abnormal angiogram that is usually done at the time that a cardiac catheterization (heart catheterization) is performed. A person will have no symptoms referable to this blockage and will only know of the abnormality because their physician informs them of such! This is generally referred to as Fontaine’s Class I.
The next “level” of ischemia is that of claudication. This is manifest by cramping pain that occurs with walking. It most often affects the calf muscles and generally occurs at a rather fixed distance (usually measured in blocks.) Depending on the severity of the ischemia—either by its level of lifestyle interference or by distance at which symptoms begin—it is referred to as Fontaine’s Class IIa or IIb.
Rest Pain is the next Stage (III) in the Fontaine classification of leg ischemia. This is typified by pain that occurs even in the absence of significant stress on the legs. It often occurs in the evenings awakening the patient from sleep. Quite often, hanging the leg from the side of the bed will improve the painful symptoms that are experienced. The foot will often turn a light purple or deep red-violet color as it is held in a dependent condition—often referred to as “dependent rubor.” This is a sign of significant leg ischemia and warrants aggressive intervention.
The final stage of leg ischemia (Fontaine Level IV) is tissue loss—seen as a non-healing sore or gangrene. This level (along with rest pain) is appropriately referred to as “limb-threatening ischemia” and must be evaluated appropriately by those with expertise in this area. Ignoring this degree of ischemia will very likely lead to limb loss (amputation) at some point in the future!
~ The Cardiovascular Care Group ~
The next “level” of ischemia is that of claudication. This is manifest by cramping pain that occurs with walking. It most often affects the calf muscles and generally occurs at a rather fixed distance (usually measured in blocks.) Depending on the severity of the ischemia—either by its level of lifestyle interference or by distance at which symptoms begin—it is referred to as Fontaine’s Class IIa or IIb.
Rest Pain is the next Stage (III) in the Fontaine classification of leg ischemia. This is typified by pain that occurs even in the absence of significant stress on the legs. It often occurs in the evenings awakening the patient from sleep. Quite often, hanging the leg from the side of the bed will improve the painful symptoms that are experienced. The foot will often turn a light purple or deep red-violet color as it is held in a dependent condition—often referred to as “dependent rubor.” This is a sign of significant leg ischemia and warrants aggressive intervention.
The final stage of leg ischemia (Fontaine Level IV) is tissue loss—seen as a non-healing sore or gangrene. This level (along with rest pain) is appropriately referred to as “limb-threatening ischemia” and must be evaluated appropriately by those with expertise in this area. Ignoring this degree of ischemia will very likely lead to limb loss (amputation) at some point in the future!
~ The Cardiovascular Care Group ~
Peripheral Vascular Disease
What is peripheral vascular disease?
This refers to diseases of blood vessels outside the heart and brain. It's often a narrowing of vessels that carry blood to the legs, arms, stomach or kidneys. There are two types of these circulation disorders:
* Functional peripheral vascular diseases don't have an organic cause. They don't involve defects in blood vessels' structure. They're usually short-term effects related to "spasm" that may come and go. Raynaud's disease is an example. It can be triggered by cold temperatures, emotional stress, working with vibrating machinery or smoking.
* Organic peripheral vascular diseases are caused by structural changes in the blood vessels, such as inflammation and tissue damage. Peripheral artery disease is an example. It's caused by fatty buildups in arteries that block normal blood flow.
What is peripheral artery disease?
Peripheral artery disease (PAD) is a condition similar to coronary artery disease and carotid artery disease. In PAD, fatty deposits build up in the inner linings of the artery walls. These blockages restrict blood circulation, mainly in arteries leading to the kidneys, stomach, arms, legs and feet. In its early stages a common symptom is cramping or fatigue in the legs and buttocks during activity. Such cramping subsides when the person stands still. This is called "intermittent claudication." People with PAD often have fatty buildup in the arteries of the heart and brain. Because of this association, most people with PAD have a higher risk of death from heart attack and stroke.
How is peripheral artery disease diagnosed and treated?
Techniques used to diagnose PAD include a medical history, physical exam, ultrasound, X-ray angiography and magnetic resonance imaging angiography (MRA).
Most people with PAD can be treated with lifestyle changes, medications or both. Lifestyle changes to lower your risk include:
*
Stop smoking (smokers have a particularly strong risk of PAD).
*
Control diabetes.
*
Control blood pressure.
*
Be physically active (including a supervised exercise program).
*
Eat a low-saturated-fat, low-cholesterol diet.
PAD may require drug treatment, too. Drugs include:
*
medicines to help improve walking distance (cilostazol and pentoxifylline).
*
antiplatelet agents.
*
cholesterol-lowering agents (statins).
In a minority of patients, lifestyle modifications alone aren't sufficient. In these cases, angioplasty or surgery may be necessary.
Angioplasty is a non-surgical procedure that can be used to dilate (widen) narrowed or blocked peripheral arteries. A thin tube called a catheter with a deflated balloon on its tip is passed into the narrowed artery segment. The balloon is then inflated, compressing the plaque and dilating the narrowed artery so that blood can flow more easily. Then the balloon is deflated and the catheter is withdrawn.
Often a stent — a cylindrical, wire mesh tube — is placed in the narrowed artery with a catheter. There the stent expands and locks open. It stays in that spot, keeping the diseased artery open.
If the narrowing involves a long portion of an artery, surgery may be necessary. A vein from another part of the body or a synthetic blood vessel is used. It's attached above and below the blocked area to detour blood around the blocked spot.
~ American Heart Association ~
This refers to diseases of blood vessels outside the heart and brain. It's often a narrowing of vessels that carry blood to the legs, arms, stomach or kidneys. There are two types of these circulation disorders:
* Functional peripheral vascular diseases don't have an organic cause. They don't involve defects in blood vessels' structure. They're usually short-term effects related to "spasm" that may come and go. Raynaud's disease is an example. It can be triggered by cold temperatures, emotional stress, working with vibrating machinery or smoking.
* Organic peripheral vascular diseases are caused by structural changes in the blood vessels, such as inflammation and tissue damage. Peripheral artery disease is an example. It's caused by fatty buildups in arteries that block normal blood flow.
What is peripheral artery disease?
Peripheral artery disease (PAD) is a condition similar to coronary artery disease and carotid artery disease. In PAD, fatty deposits build up in the inner linings of the artery walls. These blockages restrict blood circulation, mainly in arteries leading to the kidneys, stomach, arms, legs and feet. In its early stages a common symptom is cramping or fatigue in the legs and buttocks during activity. Such cramping subsides when the person stands still. This is called "intermittent claudication." People with PAD often have fatty buildup in the arteries of the heart and brain. Because of this association, most people with PAD have a higher risk of death from heart attack and stroke.
How is peripheral artery disease diagnosed and treated?
Techniques used to diagnose PAD include a medical history, physical exam, ultrasound, X-ray angiography and magnetic resonance imaging angiography (MRA).
Most people with PAD can be treated with lifestyle changes, medications or both. Lifestyle changes to lower your risk include:
*
Stop smoking (smokers have a particularly strong risk of PAD).
*
Control diabetes.
*
Control blood pressure.
*
Be physically active (including a supervised exercise program).
*
Eat a low-saturated-fat, low-cholesterol diet.
PAD may require drug treatment, too. Drugs include:
*
medicines to help improve walking distance (cilostazol and pentoxifylline).
*
antiplatelet agents.
*
cholesterol-lowering agents (statins).
In a minority of patients, lifestyle modifications alone aren't sufficient. In these cases, angioplasty or surgery may be necessary.
Angioplasty is a non-surgical procedure that can be used to dilate (widen) narrowed or blocked peripheral arteries. A thin tube called a catheter with a deflated balloon on its tip is passed into the narrowed artery segment. The balloon is then inflated, compressing the plaque and dilating the narrowed artery so that blood can flow more easily. Then the balloon is deflated and the catheter is withdrawn.
Often a stent — a cylindrical, wire mesh tube — is placed in the narrowed artery with a catheter. There the stent expands and locks open. It stays in that spot, keeping the diseased artery open.
If the narrowing involves a long portion of an artery, surgery may be necessary. A vein from another part of the body or a synthetic blood vessel is used. It's attached above and below the blocked area to detour blood around the blocked spot.
~ American Heart Association ~
Foot Pain and Diabetes
Foot pain can certainly be caused by any number of reasons. However, foot pain resulting from diabetes is both painful and very common for those living with diabetes.
Diabetes and foot pain is generally defined by four different types.
A nerve problem (where the nerves themselves are affected by the disease) called peripheral neuropathy is the most common source of foot pain tied to diabetes. Peripheral neuropathy comes in the form of sensory, motor, and autonomic neuropathy.
Sensory neuropathy is the most common and is defined by symptoms where the amount of pain is much greater than the source that is causing the pain. As an example, just touching, or lightly pulling on your socks triggers a painful reaction. Also, with sensory neuropathy you may experience some numbness along with tingling, burning, or even stabbing type pain symptoms.
Because blood sugar can be a player in this type of pain, check your blood sugar levels for the past several weeks to see if perhaps there is an upward trend toward high levels.
Relief is of the utmost importance in these cases and can come from various applications. Massaging your feet or using a foot roller can sometimes drop the level of pain. Anything you can do from a shoe perspective such as cushioned supports and inserts can assist as well. Anything to help mitigate the pressure and pounding of daily activities on the foot and/or any rubbing or chaffing is beneficial. There are also prescription drugs that your doctor can recommend that will often times work.
When the nerves to the muscles become affected by diabetes (motor neuropathy), your muscles will begin to feel weak and achy. Although the smaller muscles of the feet aren't usually the first to be affected, your balance can eventually become affected which may cause alignment problems and/or rubbing on the feet which ultimately results in pain. Support, exercise, stretching, and massage are your best weapon against motor neuropathy. Keeping your muscles healthy and flexible is a key element in relieving this type of foot pain.
Autonomic neuropathy affects the nerves that we don't consciously control, hence the 'auto' of autonomic. With this condition existing your sweating triggers are altered and as such you may suffer from dry or cracked skin. For your feet this may result in a build up of foot calluses, thickened nails and such that lead to foot pain. The daily use of conditioning agents formulated specifically for diabetes can aid or prevent this problem.
With diabetic people proper circulation is a primary concern. Circulation problems in the feet can cause severe pain. Addressing circulation problems should always be done in conjunction with your medical doctor. Various approaches may include an exercise program, physical therapy, medication, or even surgical procedures, but again, consult with your physician before considering any strategy that involves addressing a circulation issue.
With diabetic people muscle and joint pain is not uncommon. If tendons and joints begin to stiffen coupled with imbalances associated with peripheral neuropathy and walking alignment occurs, the foot and the joints become painful. In fact, if the walking misalignments continue, this can lead to other foot disorders such as corns, bunions, and hammertoe.
People living with diabetes are more susceptible to infections within their body because of the changes that have taken place in their body. If a bacterial infection attacks the foot, the foot can become red, experience swelling, feel warm, and be painful. Keeping the immune system as healthy as possible by controlling your blood sugar, proper nutrition, and exercise, should be a top priority in your defense against infections.
If you are afflicted with diabetes, in addition to being mindful of the above information, work closely with your primary care physician to ensure that you receive proper information and care for your personal situation.
~Ezine Articles ~
Diabetes and foot pain is generally defined by four different types.
A nerve problem (where the nerves themselves are affected by the disease) called peripheral neuropathy is the most common source of foot pain tied to diabetes. Peripheral neuropathy comes in the form of sensory, motor, and autonomic neuropathy.
Sensory neuropathy is the most common and is defined by symptoms where the amount of pain is much greater than the source that is causing the pain. As an example, just touching, or lightly pulling on your socks triggers a painful reaction. Also, with sensory neuropathy you may experience some numbness along with tingling, burning, or even stabbing type pain symptoms.
Because blood sugar can be a player in this type of pain, check your blood sugar levels for the past several weeks to see if perhaps there is an upward trend toward high levels.
Relief is of the utmost importance in these cases and can come from various applications. Massaging your feet or using a foot roller can sometimes drop the level of pain. Anything you can do from a shoe perspective such as cushioned supports and inserts can assist as well. Anything to help mitigate the pressure and pounding of daily activities on the foot and/or any rubbing or chaffing is beneficial. There are also prescription drugs that your doctor can recommend that will often times work.
When the nerves to the muscles become affected by diabetes (motor neuropathy), your muscles will begin to feel weak and achy. Although the smaller muscles of the feet aren't usually the first to be affected, your balance can eventually become affected which may cause alignment problems and/or rubbing on the feet which ultimately results in pain. Support, exercise, stretching, and massage are your best weapon against motor neuropathy. Keeping your muscles healthy and flexible is a key element in relieving this type of foot pain.
Autonomic neuropathy affects the nerves that we don't consciously control, hence the 'auto' of autonomic. With this condition existing your sweating triggers are altered and as such you may suffer from dry or cracked skin. For your feet this may result in a build up of foot calluses, thickened nails and such that lead to foot pain. The daily use of conditioning agents formulated specifically for diabetes can aid or prevent this problem.
With diabetic people proper circulation is a primary concern. Circulation problems in the feet can cause severe pain. Addressing circulation problems should always be done in conjunction with your medical doctor. Various approaches may include an exercise program, physical therapy, medication, or even surgical procedures, but again, consult with your physician before considering any strategy that involves addressing a circulation issue.
With diabetic people muscle and joint pain is not uncommon. If tendons and joints begin to stiffen coupled with imbalances associated with peripheral neuropathy and walking alignment occurs, the foot and the joints become painful. In fact, if the walking misalignments continue, this can lead to other foot disorders such as corns, bunions, and hammertoe.
People living with diabetes are more susceptible to infections within their body because of the changes that have taken place in their body. If a bacterial infection attacks the foot, the foot can become red, experience swelling, feel warm, and be painful. Keeping the immune system as healthy as possible by controlling your blood sugar, proper nutrition, and exercise, should be a top priority in your defense against infections.
If you are afflicted with diabetes, in addition to being mindful of the above information, work closely with your primary care physician to ensure that you receive proper information and care for your personal situation.
~Ezine Articles ~
Tuesday, October 6, 2009
Diabetes: PAD and Limb Loss
Peripheral Arterial Disease (PAD) and Limb Loss
Peripheral arterial disease (PAD) is a form of artheroscelorisis (hardening of the arteries). In PAD, fat builds up inside the artery (blood vessel) walls. Over time, this causes a blockage that can keep your blood from flowing properly. PAD may result in blockages in the brain, arms, kidneys, and legs.
Diabetes is a major cause of PAD. People with diabetes are unable to properly digest the sugar they eat. This sugar builds up and causes changes in their blood vessels. These changes lead to circulation problems. PAD is a risk factor for foot ulcers that can lead to amputation in diabetic patients.
How many people have PAD?
* As many as 10 million people in the United States have PAD.
* In 1996, an estimated 128,588 individuals lost a limb because of PAD.
What are the risk factors?
* Diabetes. People with diabetes are at greater risk for severe PAD. People with diabetes are five times more likely to have an amputation due to PAD.
* Age. The risk of limb loss due to PAD increases with age. People 65 or older are two to three times more likely to have an amputation.
* Gender. Men with PAD are twice as likely to undergo an amputation as women.
* Race/ethnicity. Some racial and ethnic groups have a higher risk of amputation (i.e., African Americans, Latino Americans, and Native Americans). This is because they are at increased risk for diabetes and cardiovascular disease.
~ dLife ~
Peripheral arterial disease (PAD) is a form of artheroscelorisis (hardening of the arteries). In PAD, fat builds up inside the artery (blood vessel) walls. Over time, this causes a blockage that can keep your blood from flowing properly. PAD may result in blockages in the brain, arms, kidneys, and legs.
Diabetes is a major cause of PAD. People with diabetes are unable to properly digest the sugar they eat. This sugar builds up and causes changes in their blood vessels. These changes lead to circulation problems. PAD is a risk factor for foot ulcers that can lead to amputation in diabetic patients.
How many people have PAD?
* As many as 10 million people in the United States have PAD.
* In 1996, an estimated 128,588 individuals lost a limb because of PAD.
What are the risk factors?
* Diabetes. People with diabetes are at greater risk for severe PAD. People with diabetes are five times more likely to have an amputation due to PAD.
* Age. The risk of limb loss due to PAD increases with age. People 65 or older are two to three times more likely to have an amputation.
* Gender. Men with PAD are twice as likely to undergo an amputation as women.
* Race/ethnicity. Some racial and ethnic groups have a higher risk of amputation (i.e., African Americans, Latino Americans, and Native Americans). This is because they are at increased risk for diabetes and cardiovascular disease.
~ dLife ~
Tuesday, September 22, 2009
Diabetes & Feet
Diabetes affects the body's blood circulation which in turn affects the feet. Extreme cases of nerve and foot disorders (neuropathy) may lead to foot/leg amputations also known as lower extremity amputations or LEAs.
Why do people with diabetes have to take care of their feet more than those with no diabetes? According to the American Diabetes Association by the time type 2 diabetes is diagnosed, 50% of patients already show early signs of foot complications. People with diabetes are 5 times more likely to develop "peripheral neuropathy" (nerve damage in extremities) than the general population. Checking feet daily and having a doctor examine the feet can help prevent serious complications.
What are some symptoms of peripheral neuropathy "complications"?
Loss of feeling in feet. Foot sores that do not heal. Numbness, tingling or burning sensation in feet.
How can these "complications" be prevented?
Keep blood sugar (glucose) close to your goal. Don't smoke.
Get blood pressure checked regularly. Continue taking medication for blood pressure if prescribed by your doctor.
Check feet thoroughly ever day.
Report any problems to your health care provider.
How to Care for Your Feet:
Check feet daily for cuts, sores, red spots, swelling, and infected toenails.
Keep the top and bottom of feet's skin soft and smooth by using skin cream, lotion, or petroleum jelly.
Smooth corns and calluses gently -- check with your healthcare provider for proper care.
Trim toenails each week or as needed -- Cut nails straight across and file the edges. if you cannot see well, or if your toenails are thick or yellowed, have a foot care doctor trim them.
Never walk barefoot -- wear shoes and socks (preferably cotton or wool) at all times to protect feet from injury. Remember to shake out your shoes before putting them on since a small pebble or glass can lead to foot problems.
Wear shoes that fit well. Shape of feet may change due to poor fitting shoes. If you have lost feeling in your feet ask your health care provider for advice on proper shoes.
Protect feet from extreme heat or cold
(Adapted from ADA diabetes educational material)
Why do people with diabetes have to take care of their feet more than those with no diabetes? According to the American Diabetes Association by the time type 2 diabetes is diagnosed, 50% of patients already show early signs of foot complications. People with diabetes are 5 times more likely to develop "peripheral neuropathy" (nerve damage in extremities) than the general population. Checking feet daily and having a doctor examine the feet can help prevent serious complications.
What are some symptoms of peripheral neuropathy "complications"?
Loss of feeling in feet. Foot sores that do not heal. Numbness, tingling or burning sensation in feet.
How can these "complications" be prevented?
Keep blood sugar (glucose) close to your goal. Don't smoke.
Get blood pressure checked regularly. Continue taking medication for blood pressure if prescribed by your doctor.
Check feet thoroughly ever day.
Report any problems to your health care provider.
How to Care for Your Feet:
Check feet daily for cuts, sores, red spots, swelling, and infected toenails.
Keep the top and bottom of feet's skin soft and smooth by using skin cream, lotion, or petroleum jelly.
Smooth corns and calluses gently -- check with your healthcare provider for proper care.
Trim toenails each week or as needed -- Cut nails straight across and file the edges. if you cannot see well, or if your toenails are thick or yellowed, have a foot care doctor trim them.
Never walk barefoot -- wear shoes and socks (preferably cotton or wool) at all times to protect feet from injury. Remember to shake out your shoes before putting them on since a small pebble or glass can lead to foot problems.
Wear shoes that fit well. Shape of feet may change due to poor fitting shoes. If you have lost feeling in your feet ask your health care provider for advice on proper shoes.
Protect feet from extreme heat or cold
(Adapted from ADA diabetes educational material)
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