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)

Monday, September 21, 2009

Diabetes and P.A.D.

What is the link between Diabetes and P.A.D.?

People with diabetes are at higher risk for having P.A.D. Some studies have found that one out of three people with diabetes over age 50 has P.A.D., and P.A.D. is even more common in African Americans and Hispanics who have diabetes.

Having P.A.D. and diabetes can be a very serious problem. People who have both diseases are much more likely to have a heart attack or stroke than those who just have P.A.D., and they are more likely to die at a younger age.

Because many people with diabetes do not have feeling in their feet or legs due to nerve disease, they may have P.A.D. but cannot feel any symptoms. As a result, they do not know they have P.A.D., or they may have it for a long time before it is diagnosed. Further, when blood flow to your feet and legs is narrowed or blocked due to P.A.D., it takes longer for cuts or wounds to heal, which may increase the risk for amputation (or losing a foot or leg).

If you have diabetes, talk with your health care provider right away if you have any of these P.A.D. warning signs:

* Fatigue, tiredness or pain in your legs, thighs or buttocks that always happens when you walk but that goes away when you rest.
* Foot or toe pain at rest that often disturbs your sleep.
* Skin sores or wounds on your feet or toes that are slow to heal.

Most people with P.A.D. do not have any symptoms. Guidelines released by leading vascular organizations recommend that people with diabetes over the age of 50 be tested for P.A.D. Testing is also recommended for people with diabetes under the age of 50 with other risk factors, such as smoking, high blood pressure or cholesterol problems. ~P.A.D. Coalition~

Encompass partners with Dialysis Clinics to secure complete diagnosis, care and treatment options for patients suffering from critical lower limb ischemia and foot wounds. The Encompass Network is a web base application that provides clinics with the tools for a thorough screening, systematic refereeing, and complete patient follow through from diagnosis to healing. Our user friendly system requires minimal staff time and the automated referring systems allow the attending physicians to review data and refer patient to a specialist based upon the patient assessment profile and easy “refer now” option. The assessment profile will keep the clinic informed with patient diagnosis, treatments and updates that go on outside of the clinic. You will see the results.

For questions, or to partner with Encompass Network Partners, contact:
Kelly Burleson, Director of Client Relations, kburleson@encompassnetworkpartners.com

Wednesday, September 16, 2009

Stop PAD Petition Drive to Expand Medicare Coverage to Test Patients for Peripheral Arterial Disease

September 15, 2009 10:05 AM Eastern Daylight Time

THE SAGE GROUP Supports the “Stop P.A.D.” Petition Drive to Expand Medicare Coverage to Test Patients for Peripheral Arterial Disease

ATLANTA--(BUSINESS WIRE)--In recognition of National P.A.D. Awareness Month, Mary L. Yost, President of THE SAGE GROUP recommends that patients, relatives, and the medical community join the campaign to increase access to a simple noninvasive test to diagnose peripheral arterial disease (abbreviated P.A.D. or PAD).

This inexpensive test known as the ankle-brachial index (ABI) is a cost-effective method to detect disease in asymptomatic patients. Although Medicare currently offers testing for patients with symptoms, PAD is most commonly asymptomatic.

“Asymptomatic does not mean that the disease is benign. PAD is not just a leg problem,” declared Ms. Yost. Within 5 years, 50% of patients will experience a heart attack or stroke; 30% will be fatal.

PAD, also known as peripheral vascular disease (PVD), is characterized by a reduction of blood flow to the lower limbs due to atherosclerosis.

In the severe stages of PAD (critical limb ischemia or CLI) blood flow is so inadequate that ulcerations and gangrene occur. Once PAD has progressed to CLI, the risks of limb loss and mortality increase. At six months, approximately 20% of those with CLI will die; another 35% will experience amputation.

THE SAGE GROUP estimates that approximately 160,000 PAD-related amputations are performed annually in the U.S. “The tragedy is that early diagnosis and treatment could eliminate many of these amputations,” declared Yost.

Ms. Yost noted, “As the nation debates healthcare reform, it is important to keep in mind that early diagnosis is a key factor in reducing the costs of chronic diseases, such as PAD.”

If diagnosed in the early stages, PAD patients can be treated with the appropriate lifestyle modifications and drug therapies to reduce the risks of heart attack and stroke; exercise therapy to reduce the pain of claudication; or if blockages are more severe with minimally invasive revascularization technologies.

“However, if the disease is not diagnosed until critical ischemia occurs, interventional therapy is more costly. If gangrene is so severe that the limb cannot be salvaged the patient must undergo amputation, the most costly procedure,” Yost elaborated.

“Amputation is not only extremely undesirable from the patient’s viewpoint it is socially undesirable in terms of costs. The inability of a large percentage of these amputees to live independently adds significantly to the total cost burden,” stated Yost.

“Since the ABI test is generally not performed on asymptomatic PAD patients, significant numbers remain undiagnosed until they suffer a heart attack or develop ulcers and gangrene. In our opinion this needlessly increases overall costs,” Ms. Yost observed. “We have estimated that a 25% reduction in the number of amputations could save $2.9 billion in healthcare expenditures. Based on today’s procedure costs and long term care costs this is probably a conservative number,” she continued.

THE SAGE GROUP estimates that 16-17 million U.S. citizens currently have PAD and 2.2 to 2.7 million of them suffer from critical limb ischemia.

Additional information about PAD and vascular diseases can be found at the nonprofit Vascular Disease Foundation site at www.vdf.org.

To sign the petition, go to www.padcoalition.org/petition and complete the online form.

THE SAGE GROUP, an independent market research and consulting company, specializes in atherosclerotic disease in the lower limbs, specifically PAD (Peripheral Arterial Disease), CLI (Critical Limb Ischemia) and ALI (Acute Limb Ischemia).

Wednesday, September 9, 2009

Doctors aim to increase awareness of peripheral arterial disease

Peripheral arterial disease is one of the most common types of cardiovascular disease - and also one of the least publicized, health officials say.

According to Dr. Robert Wilkins, a board-certified cardiovascular specialist with Southern Heart Center, a service of Hattiesburg Clinic, this lack of awareness could be deadly.

During September, which is "National P.A.D. Awareness Month," Wilkins and his colleagues Drs. Craig Thieling, Ben Rester and Randel Smith, are committed to increasing the public's knowledge of this disease.

P.A.D. affects about 10 million Americans and occurs when the arteries in the legs or other non-heart arteries become narrowed or clogged by fatty deposits or plaque. The buildup of plaque causes arteries to harden and narrow, a process called atherosclerosis. When leg arteries are hardened and clogged, blood flow to the legs and feet is reduced.

The most common type of P.A.D. is the extertional leg pain, burning or tightness known as "claudication."

When not diagnosed and treated early, this may lead to a severe decrease in leg blood flow, a condition known as "critical leg ischemia," a condition that can result in a possible amputation.

P.A.D. is a warning sign that other arteries in the body, including those in the heart and brain, may also be blocked.

This condition is associated with a high risk of heart attack, stroke and death.

Unfortunately, many people may not recognize their leg pain symptoms as P.A.D.

"People were not aware of the risk factors for this disease, the increased risk for heart attack and stroke associated with this disease, or simple diagnostic tests which can identify this disease," Wilkins said. "In addition, many people are not aware of the numerous non-surgical, minimally invasive treatment options for this disease."

Southern Heart Center has now developed a special P.A.D. treatment team including: cardiovascular medicine physicians and endovascular specialists, acute care nurse practitioners, physician assistants and nurses.

Southern Heart Center also has a number of events scheduled throughout September to increase public awareness of P.A.D.

These events include speaking to senior and civic organizations, presenting at Forrest General Hospital's Spirit of Women luncheon, and working with primary care providers in this region.

The center also will sponsor three vascular disease screening events. The screenings will be provided in Hattiesburg, Picayune and Magee.

"Our cardiovascular physicians have made themselves available to speak to any organization which wants to learn more about this very serious but often treatable disease" said Ken Smith, Southern Heart Center's administrator. "They are very passionate about the need to increase public awareness of the diagnosis and treatment of peripheral arterial disease."

For more information, visit www.hattiesburgclinic.com or call Southern Heart Center at 268-5800.

Tuesday, September 8, 2009

Top Warning Signs and Symptoms of Diabetes

Many of the signs of Type 1 and Type 2 diabetes are similar. In both, there is too much glucose in the blood and not enough in the cells of your body. High glucose levels in Type I are due to a lack of insulin because the insulin producing cells have been destroyed. Type 2 diabetes occurs when the body's cells become resistant to insulin that is being produced. Either way, your cells aren't getting the glucose that they need, and your body lets you know by giving you these signs and symptoms.

Frequent trips to the bathroom:

Are you visiting the bathroom much more lately? Does it seem like you urinate all day long? Urination becomes more frequent when there is too much glucose in the blood. If insulin is nonexistent or ineffective, the kidneys can't filter glucose back to the blood. They become overwhelmed and try to draw extra water out of the blood to dilute the glucose. This keeps your bladder full and it keeps you running to the bathroom.

Unquenchable Thirst:
If it feels like you can't get enough water and you're drinking much more than usual, it could be a sign of diabetes, especially if it seems to go hand in hand with frequent urination. If your body is pulling extra water out of your blood and you're running to the bathroom more, you will become dehydrated and feel the need to drink more to replace the water that you are losing.

Losing Weight Without Trying:

This symptom is more noticeable with Type 1 diabetes. In Type 1, the pancreas stops making insulin, possibly due to a viral attack on pancreas cells or because an autoimmune response makes the body attack the insulin producing cells. The body desperately looks for an energy source because the cells aren't getting glucose. It starts to break down muscle tissue and fat for energy. Type 2 happens gradually with increasing insulin resistance so weight loss is not as noticeable.

Weakness and Fatigue:

It's that bad boy glucose again. Glucose from the food we eat travels into the bloodstream where insulin is supposed to help it transition into the cells of our body. The cells use it to produce the energy we need to live. When the insulin isn't there or if the cells don't react to it anymore, then the glucose stays outside the cells in the bloodstream. The cells become energy starved and you feel tired and run down.

Tingling or Numbness in Your Hands, Legs or Feet:

This symptom is called neuropathy. It occurs gradually over time as consistently high glucose in the blood damages the nervous system, particularly in the extremities. Type 2 diabetes is a gradual onset, and people are often not aware that they have it. Therefore, blood sugar might have been high for more than a few years before a diagnosis is made. Nerve damage can creep up without our knowledge. Neuropathy can very often improve when tighter blood glucose control is achieved.

Other Signs and Symptoms That Can Occur:

Blurred vision, skin that is dry or itchy, frequent infections or cuts and bruises that take a long time to heal are also signs that something is amiss. Again, when these signs are associated with diabetes, they are the result of high glucose levels in the body. If you notice any of the above signs, schedule an appointment with your doctor. He or she will be able to tell you if you have reason to be concerned about a diagnosis of diabetes.

~By Debra Manzella, R.N., About.com~