Diabetic Foot Care

Diabetes: Symptoms & Startling Statistics

The chronic disease, Diabetes mellitus, affects the lives of nearly 24 million Americans, nearly 6 million of whom are unaware that they even have the disease. In the year 2007 alone, 1.6 million new cases of diabetes were diagnosed in people 20 years old and above. The disease is characterized by the inability to manufacture or properly use insulin which impairs the body’s ability to convert sugars, starches and other foods into energy. The long-term effects of elevated blood sugar (hyperglycemia) include damage to the eyes, heart, feet, kidneys, nerves and blood vessels.

Symptoms of hyperglycemia include:

• excessive thirst
• frequent urination
• extreme hunger
• unexplained weight loss
• tingling or numbness of the feet or hands
• fatigue
• blurred vision
• slow-to-heal wounds
• susceptibility to certain infections

People who may be experiencing any of these symptoms and have not yet been tested for diabetes are putting themselves at considerable risk and should see a doctor immediately.

A key part of controlling your diabetes is by testing your blood sugar often. Ask your physician how often you should test and what your blood sugar levels should be. Testing your blood and then treating high blood sugar early will help to prevent complications.

The socioeconomic costs of diabetes are vast. In 2007, the estimated total annual economic cost of diabetes was an estimated $174 billion — about $116 billion of which were direct costs from the disease with $58 billion indirectly related. The sixth leading cause of death in the United States is diabetes. People with diabetes are two to four times more likely to experience a stroke and heart disease.

Especially alarming is the growth of the disease on a global scale. The World Health Organization (WHO) anticipates the number of new diabetes cases to double in the next 25 years. The numbers are expected to grow from 135 million to nearly 300 million. Much of this growth is expected to occur in developing countries where aging, unhealthy diets, sedentary lifestyles, and obesity will contribute to the onset of the disease.

According to a recent survey, nearly 86,000 lower limbs are amputated annually due to diabetic complications. Accounting for about 44 percent of all new cases, diabetes is the leading cause of end-stage kidney disease. Diabetes is also the leading cause of new cases of blindness among people aged 20 to 74.

While there is still no cure for diabetes, there is hope. With proper diet, exercise, medical care and careful management at home, a person with diabetes can keep the most serious of the consequences at bay and enjoy a long, full life.

How Do You Get Diabetes?

It's unknown why people develop diabetes, but once diagnosed, the disease is present for life. It is a hereditary disorder, and certain genetic indicators are known to increase the risk of developing the disease. Type 1 diabetes, previously known as insulin-dependent diabetes mellitus or juvenile-onset diabetes, afflicts five to ten percent of diagnosed cases of diabetes. This type occurs most frequently in children and adolescents than in adults, and is caused by the inability of the pancreas to produce the insulin needed for survival. Type 2 diabetes, previously called noninsulin-dependent diabetes mellitus or adult-onset diabetes, affects the other 90-95 percent of all diagnosed cases of diabetes, many of whom use oral medication or injectable insulin to control the disease. The vast majority of those people (80 percent or more) are overweight; many of them obese, as obesity itself can cause insulin resistance.

Certain characteristics put people at a higher risk for developing Type 2 diabetes. These include:

• Obesity
• A family history of the disease
• Prior history of developing diabetes while pregnant
• Being over the age of 40
• Being a member of one of the following ethnic groups: African American, Latino American, Asian American,  Native American, Pacific Islander

African Americans are 1.7 times more likely to have diabetes than the general population, with 25 percent of African Americans between the ages of 65 and 74 diagnosed with the disease. Hispanic Americans are almost twice as likely to develop type 2 diabetes, which affects 10.6 percent of that population group. Native Americans are at a significantly increased risk for developing diabetes, and 12.2 percent of the population suffers from the disease. In some Native American tribes, as many as 50 percent of its members are diabetic.

Weight is the most important risk factor, with more than 80 percent of diabetics classified as overweight.

Your Podiatric Physician's Role

Because diabetes is a systemic disease affecting many different parts of the body, ideal case management requires a team approach. The podiatric physician, as an integral part of the treatment team, has documented success in the prevention of amputations. The key to amputation prevention in diabetic patients is early recognition and regular foot screenings, at least annually, from a podiatric physician.

In addition to these checkups, there are warning signs that you should be aware of so that they may be identified and called to the attention of the family physician or podiatrist.  They include:

• Swelling of the foot or ankle
• Skin color changes
• Pain in the legs
• Elevation in skin temperature
• Open sores on the feet that are slow to heal
• Ingrown and fungal toenails
• Bleeding corns and calluses
• Dry cracks in the skin, especially around the heel

Wound Healing

Ulceration is a common occurrence with the diabetic foot and should be carefully treated and monitored by a podiatry specialist to avoid the need for amputations. Poorly fitting shoes, or something as trivial as a stocking seam, can create a wound that may not be felt by someone who experiences diminished skin sensation. Left unattended, such ulcers can quickly become infected and lead to more serious consequences. Your podiatric physician knows how to treat and prevent these wounds and can serve as an important factor in keeping your feet healthy and strong. Newly developed to the science of wound healing are remarkable products that have the appearance and handling characteristics of human skin. These living, skin-like products are applied to wounds that are properly prepared by the podiatric physician. Clinical trials have shown impressive success rates.