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Diabetic and Vascular Disease

Diabetes Mellitus

Diabetes results when your body fails to produce or properly use insulin. The body's failure to produce any insulin is Type I diabetes, while the failure to properly use insulin is Type II diabetes. Typically Type II is preventable and reversible, and is a newer diagnosis in younger obese children, when it was originally seen in our older obese or metabolically challenged patients. Diabetics are at risk for sensation loss in their feet and hands, vascular occlusive disease, and weakened immune systems, affecting the ability to fight infections and chronic diseases. Because of this, foot ulceration with infection is a leading cause of hospitalization for diabetics.  Diabetics have a more than 10 times higher likelihood of toe, foot or leg amputations over non-diabetics. Successful ulcer prevention begins at home. It is important to check your feet and feel inside your shoes daily. Wearing shoes and proper socks at all times can also help. If the sensation is dimished or lost, then a snug shoe can rub and cause blisters which can become infected without warning to the patient.  It is very important to maintain a healthy diet, with increased lean proteins, low carbohydrates, and less sugars and low glycemic index foods. Watch your glucose levels daily, and always follow up regularly with a podiatrist and your primary care physician.

If a diabetic patient develops a wound or ulcer, it is important to evaluate and treat the ulcer immediately and treat it with regular visits at the office. This will include cutting edge wound care treatments, and shoe gear considerations in order for the wound to be off loaded and heal properly.

Peripheral Neuropathy

Peripheral neuropathy is a disorder the affects the peripheral small nerves within the feet and legs and even the hands.  These nerves exit out of the spinal cord and then enter into to muscles, and skin of the legs feet and hands, and even can affect the internal organs. Although Neuropathy affects the diabetic population at a very accelerated rate (approximately 60-70% of all diabetics will develop neuropathy) it can affect other patients as well. Those patients may have a history of significant alcohol use, B vitamin deficiencies, and even autoimmune disorders, trauma, toxins, thyroid and lower back conditions. Some neuropathy issues are caused by unknown factors. Usually affecting the hands and feet, peripheral neuropathy can cause, numbness, tingling, burning, and unusual sensations or pain. Early on, it can come and go, slowly progress, or can become severe and debilitating. If diagnosed early, peripheral neuropathy can often be controlled, or even cured. Therapy is directed to treat the underlying cause and to improve the symptoms.


DIABETIC DO’S AND DON’T’S:

  1. Feel feet daily for any blisters, dry patches, or warm spots
  2. Look at your feet daily use a hand held mirror if needed.
  3. Change socks daily and discard if they have any holes in them.
  4. Feel inside your shoes daily to make sure nothing is inside that may harm the skin on the foot.
  5. If shoes are wet, rotate with another shoe and let them air out fully.
  6. Get your feet checked very regularly at our office especially if you have neuropathy or history of ulcers.

Peripheral Vascular Disease (PVD)

Peripheral vascular disease (PVD) can affect the arteries and veins. The most common type is peripheral arterial disease, or PAD. It is caused by a build-up of fatty material within the vessels, called atherosclerosis. Known to affect the arteries of the heart, brain, and smaller  leg and foot arteries.  If the blockage plaque breaks loose it may travel into other arteries and may cause heart attack, or stroke. If the plaque continually builds up, ischemic pain, cold feet, bluish skin discolorations, or gangrene can occur in the lower extremity. A simple vascular check of the extremities by a professional is very important and can help diagnose this disease early. If further diagnostic testing is required,  it can usually be done painlessly and  easily. By age 65, about 12 to 20 percent of the population will have this artery disease and if the patient smokes, has diabetes, hypertension, or high cholesterol, the odds increases many fold. Simple diet changes, exercise and cessation of smoking, can greatly reduce the odds of complications of this preventable disease.