According to the NY Times, stomach ulcers may increase risk of Diabetes...

 

Really? Ulcers Increase the Risk of Diabetes

 

By ANAHAD O'CONNOR | March 26, 2012, 2:39 PM 5

Christoph Niemann  THE FACTS  Poor diet, a lack of exercise, excess weight and genetics are the usual risk factors for Type 2 diabetes. But a new line of research suggests that in some cases, there may be a surprising contributor: the stomach bacterium known as Helicobacter pylori.People who acquire H. pylori — typically in childhood — are at a greater risk of ulcers and gastric cancer. But H. pylori also is thought to affect two digestive hormones involved in hunger and satiety.The belief is that the bacterium increases levels of ghrelin, the “hunger hormone,” which is known to promote weight gain. At the same time, H. pylori is thought to lower levels of leptin, the “satiety” hormone, which reduces appetite and promotes calorie burning.In a study published in The Journal of Infectious Diseases this year, researchers looked at more than 13,000 people in the National Health and Nutrition Examination Surveys. The data showed that people who had H. pylori in their systems also had higher levels of something called HbA1c, a compound considered a strong predictor of diabetes and metabolic syndrome, which includes high blood pressure, high blood sugar and an excess of certain fats in the bloodstream.In another recent study, in the journal Diabetes Care, scientists at the University of Michigan and elsewhere analyzed blood samples taken from 782 adults from 1998 to 1999. The scientists looked for a connection between various chronic infections and Type 2 diabetes, and found only one: People who had H. pylori in their systems were nearly three times as likely to develop diabetes as those who did not.Scientists studying the link say more research is needed. But treating H. pylori, they say, may one day be a way to control or prevent Type 2 diabetes in some people.THE BOTTOM LINEA bacterium that causes ulcers may also raise the risk of diabetes.

Tags: stomach ulcers, diabetes

A large percentage of our practice is devoted to the diabetic foot.  Complications of diabetes, such as neuropathy and peripheral arterial disease, lead to ulceration and amputation.  The following website shows the impact of diabetes, ulcers and complications. 

If you or someone you know has diabetes, please take the time to explore the link below.

http://www.diabetesfootulcer.com/

Tags: complications of diabetes, peripheral arterial diease, neuropathy, diabetes

Tags: peripheral vascular disease, diabetes, high blood pressure

Those with Diabetes are susceptible to develop a condition known as Charcot Foot. This condition can
be debilitating for patients, especially when not diagnosed expeditiously. The information below explains the condition and treatment.

What Is Charcot Foot?
Charcot foot is a condition causing weakening of the bones in the foot that can occur in people who have significant nerve damage (neuropathy). The bones are weakened enough to fracture, and with continued walking the foot eventually changes shape. As the disorder progresses, the joints collapse and the foot takes on an abnormal shape, such as a rocker-bottom appearance.

Charcot foot is a very serious condition that can lead to severe deformity, disability, and even amputation. Because of its seriousness, it is important that patients with diabetes—a disease often associated with neuropathy—take preventive measures and seek immediate care if signs or symptoms appear.



Causes
Charcot foot develops as a result of neuropathy, which decreases sensation and the ability to feel temperature, pain, or trauma. Because of diminished sensation, the patient may continue to walk—making the injury worse.

People with neuropathy (especially those who have had it for a long time) are at risk for developing Charcot foot. In addition, neuropathic patients with a tight Achilles tendon have been shown to have a tendency to develop Charcot foot.

Symptoms
The symptoms of Charcot foot may include:

Warmth to the touch (the affected foot feels warmer than the other)
Redness in the foot
Swelling in the area
Pain or soreness
Diagnosis
Early diagnosis of Charcot foot is extremely important for successful treatment. To arrive at a diagnosis, the surgeon will examine the foot and ankle and ask about events that may have occurred prior to the symptoms. X-rays and other imaging studies and tests may be ordered.

Once treatment begins, x-rays are taken periodically to aid in evaluating the status of the condition.

Non-Surgical Treatment
It is extremely important to follow the surgeon’s treatment plan for Charcot foot. Failure to do so can lead to the loss of a toe, foot, leg, or life.

Non-surgical treatment for Charcot foot consists of:

Immobilization. Because the foot and ankle are so fragile during the early stage of Charcot, they must be protected so the weakened bones can repair themselves. Complete non-weightbearing is necessary to keep the foot from further collapsing. The patient will not be able to walk on the affected foot until the surgeon determines it is safe to do so. During this period, the patient may be fitted with a cast, removable boot, or brace, and may be required to use crutches or a wheelchair. It may take the bones several months to heal, although it can take considerably longer in some patients.
Custom shoes and bracing. Shoes with special inserts may be needed after the bones have healed to enable the patient to return to daily activities—as well as help prevent recurrence of Charcot foot, development of ulcers, and possibly amputation. In cases with significant deformity, bracing is also required.
Activity modification. A modification in activity level may be needed to avoid repetitive trauma to both feet. A patient with Charcot in one foot is more likely to develop it in the other foot, so measures must be taken to protect both feet.
When is Surgery Needed?
In some cases, the Charcot deformity may become severe enough that surgery is necessary. The foot and ankle surgeon will determine the proper timing as well as the appropriate procedure for the individual case.

Preventive Care
The patient can play a vital role in preventing Charcot foot and its complications by following these measures:

Keeping blood sugar levels under control can help reduce the progression of nerve damage in the feet.
Get regular check-ups from a foot and ankle surgeon.
Check both feet every day—and see a surgeon immediately if you notice signs of Charcot foot.
Be careful to avoid injury, such as bumping the foot or overdoing an exercise program.
Follow the surgeon’s instructions for long-term treatment to prevent recurrences, ulcers, and amputation.

From: http://www.foothealthfacts.org/footankleinfo/charcot-foot.htm Tags: collapsed foot, neuroarthropathy, neuropathy, charcot foot, diabetes

New government research  shows a dramatic decline in the rate of foot and leg amputations in diabetic patients.  This is likely secondary to better treatments. 

The rate has fallen by more than half since the mid-1990s.  The Center for Disease Control reported in January 2012 that for older diabetics, amputations dropped from more than 11 to about 4 per 1,000 people.

Roughly 1 in 10 adults in the US is diabetic.  Diabetes is also the 7th leading cause of death among Americans.  Complications include poor circulation, nerve damage, slow healing wounds, infection and amputation.

In the CDC study, researchers checked national hospital discharge records for 1988-2008, looking for patients aged 40 and older who had lost a toe, foot or leg to diabetes.  They found that although the number of people with diabetes more than tripled over 2 decades, the rate of amputations after 1996 fell.

It's not clear what started the drop in amputation rate, but experts state that contributing factors include close monitoring, annual diabetic foot exams, an increase in patient education, Medicare coverage of blood sugar monitoring, protective shoes, and other medical devices.

To read more please click on the link below:

http://www.foxnews.com/health/2012/01/25/cdc-diabetes-amputations-falling-dramatically/#ixzz1kx58Rs8X

 

Tags: wound, diabetes, CDC, amputation

 

Some experts opin that in order to fight epidemics in the US such as diabetes, obesity, cardiac disease, hypertension, high cholesterol, cancer, dementia that we should regulate sugar consumption.

Dr. Robert Lustig shared his thoughts on National Public Radio last month.  A link to the transcript is below:

http://www.npr.org/2012/02/17/147047545/should-sugar-be-regulated-like-alcohol

Tags: regulation of sugar, sugar consumption, diabetes

Diabetes is currently one of the ten leading causes of death in New Jersey.  In 2009, 562,000 persons in New Jersey were estimated to have diabetes and the disease was estimated to affect the health of 8.4% of the adult population.  Not only does diabetes cause detriment to the well-being of New Jersey's citizens, but it also puts a tremendous financial burden on the state.

The total cost of diabetes in New Jersey exceeds $5.8 billion per year.

The ADA estimates that a third of this cost stems from indirect costs such as lost work productivity, and that two thirds of the cost is a direct result of medical bills.

Complication from Diabetes:  $113,738 - the average cost of each amputation

In 2009, 1,571 non-traumatic lower limb ampuatations were performed in New Jersey due to the effects of diabetes.

Diabetes is the leading cause of non-traumatic lower limb amputation; however, these amputations can be prevented.

In 2010, nearly 72% of Americans revealed foot pain had prevented them from performing their daily activities, and visits to podiatrists have been linked to improve foot health.  Research shows yearly visits to a podiatrist by those with diabetes significantly decreases the risk of lower limb amputation.  New Jersey can benefit economically and medically from encouraging its diabetes patients to visit podiatrists yearly.

From, WWW.APMA.ORG

 

Tags: economic impact, amputation, prevalence, diabetes

Tips for Fending Off Holiday Stress

Tags: diet, diabetes, stess

As written in a previous blog post, November is Diabetes Awareness Month.  The APMA (American Podiatric Medical Association) "Knock Your Socks Off" campaign is helping to raise diabetes awareness around the country.

Did you know that  66% of Hispanics are at an increased risk of developing diabetes?  This hits close to home as 27% of the population living in Cumberland County is Hispanic.

Diabetes is the number one cause of non-traumatic lower-limb amputations.  With proper foot care from a trained foot and ankle specialist (podiatrist) complications can be prevented.

In addition to being evaluated by your podiatrist, be sure to maintain tight control of your diabetes.  Some tips for better diabetic control include:

• Establish a customized plan with your family doctor and set goals
• Overcome barriers to exercise
• Make the correct food choices
• Check your blood sugar regularly and keep a log
• Maintain a healthy weight

If you or someone you know is suffering from diabetes please call Foot Care Centers at 856-691-2152 to make a preferred appointment.

Image from www.apma.org

 

Tags: Hispanic, blood sugar, amputation, Knock Your Socks Off, APMA, diabetes

The Value of Care Provided by Podiatrists:
Providing Savings to Patients and to the U.S. Health-care Delivery System
Podiatrists Prevent and Treat Complications from Diabetes
According to the CDC, nearly 26 million Americans live with diabetes. Diabetes is the leading
cause of non-traumatic lower-limb amputation; however, amputations can be prevented. A
recent study published in the Journal of the American Podiatric Medical Association (JAPMA)
compared health and risk factors for those who had seen a podiatrist for care to those who had
not and concluded that increased utilization of care by podiatrists in patients with diabetes could
result in significant direct health-care savings.
Podiatrists receive the education, training, and experience necessary to provide quality foot and
ankle care to patients, and at the same time present cost-containment solutions to our health-care
delivery and financing systems.
Access to a Podiatrist Can Lead to Savings for U.S. Health-care Delivery Systems
According to the study published in JAPMA:
 Among patients with commercial insurance, a savings of $19,686 per patient with
diabetes can be realized over a three year period if there is at least one visit to a podiatrist
in the year preceding an ulceration. Diabetic ulcerations are the primary factor leading to
lower extremity amputations.
 Among Medicare-eligible patients, a savings of $4,271 per patient with diabetes can be
realized over a three year period if there is at least one visit to a podiatrist in the year
preceding an ulceration.
 Conservatively projected, these per-patient numbers support an estimated $10.5 billion in
savings over three years if every at-risk patient sees a podiatrist at least one time in a year
preceding their ulceration.
Care by Podiatrists Offers a Positive Return on Investment
According to the same study published in JAPMA:
 Among patients with commercial insurance, each $1 invested in care by a podiatrist result
in $27 to $51 of savings.
 Among Medicare eligible patients, each $1 invested in care by podiatrists result in $9 to
$13 of savings.
For More Information:
JAPMA Study:www.apma.org/trstudy Tags: podiatrist, health care cost, diabetes

If you’re among the eight million Hispanic Americans with diabetes, seemingly minor foot problems can lead to serious complications. Receiving proper foot care from today’s podiatrist is an important part of any diabetes management plan. Whether you’ve had diabetes for years or have been recently diagnosed, be sure to “Knock Your Socks Off!” and properly inspect your feet.

Take this quiz to find out how much you know about diabetes and foot care.

http://www.apma.org/MainMenu/News/Campaigns/Diabetes.aspx

Link also en espanol Tags: quiz, diabetes

Su Equipo de Control de la Diabetes

Si bien la diabetes afecta el cuerpo negativamente de pies a cabeza, puede controlarse de manera satisfactoria con la guía y el tratamiento de un equipo de especialistas médicos. Conocer quiénes son los “jugadores del equipo” y qué hacen es esencial para garantizar que usted controle la diabetes en todo momento. Si sigue las recomendaciones de sus médicos y hace preguntas importantes sobre su atención, comprenderá plenamente qué se necesita para tratar y controlar la diabetes.

Médico de atención primaria: el médico de familia o internista desempeña el importante papel de coordinador. A menudo es el primer médico al que uno consulta después de un diagnóstico de diabetes. Es también quien remite a otros especialistas del equipo de tratamiento. Cuando elija un médico de atención primaria, pregúntele si remite a un podiatra para las complicaciones en los pies que causa la diabetes.

Endocrinólogo: especialista al que le puede enviar el médico de atención primaria. Este especialista trata muchas enfermedades internas y a menudo se le consulta para que atienda a una persona con diabetes que tiene dificultades para controlar la enfermedad.

Podiatra: también conocido como médico podiátrico, los podiatras están calificados especialmente para tratar los pies y tobillos. La diabetes puede limitar o restringir la función nerviosa y el flujo sanguíneo a los pies. Debido a este problema, los pacientes con diabetes pueden presentar complicaciones de los pies que pueden dar lugar a amputación si no se tratan. Si tiene diabetes o corre el riesgo de padecer la enfermedad, haga que un podiatra le revise los pies al menos dos veces al año para detectar síntomas, como pérdida de sensibilidad, ardor u hormigueo.

¡De hecho, la diabetes es la primera causa de amputaciones no traumáticas de extremidades inferiores en el mundo! Para encontrar un podiatra en su zona, visite www.apma.org/findapodiatrist.

Odontólogo: los pacientes con diabetes son más susceptibles a enfermedades de las encías e infecciones en la boca debido al exceso de azúcar en sangre. Por eso es importante cumplir con las citas odontológicas regulares. Asegúrese de que su odontólogo sepa si tiene diabetes y no deje de acudir a sus exámenes odontológicos cada seis meses.

Oftalmólogo u optómetra: de forma similar a cómo la diabetes restringe el flujo de sangre a los pies, la diabetes puede también afectar el flujo de sangre a los ojos y ocasionar la enfermedad del ojo diabético. Esta afección es altamente prevenible si la enfermedad se controla de manera correcta. Debe visitar al oftalmólogo para hacerse un examen de la vista una vez por año.

Cirujano vascular: la diabetes puede aumentar las probabilidades de contraer varias enfermedades vasculares. Su riesgo de padecer una enfermedad vascular aumenta con el tiempo que haya tenido diabetes, y su riesgo puede aumentar si tiene presión arterial alta, fuma, lleva una vida inactiva, tiene sobrepeso o ingiere una dieta con alto contenido graso. Asegúrese de que en su equipo de control de la diabetes haya un cirujano vascular.

Farmacéutico: un buen control de la diabetes generalmente requiere tomar medicamentos recetados. Converse con su farmacéutico para asegurarse de que comprende los riesgos del uso de medicamentos de venta libre (over-the-counter, OTC) con los medicamentos recetados.
Tags: diabetes

Diabetes is quickly becoming an epidemic in this country.  There are 26 million American children and adults living with the disease and another 79 million at risk.

The following statistics were obtained from the American Diabetes Association website www.diabetes.org.

• Every 17 seconds, someone is diagnosed with diabetes
• Diabetes kills more people each year than breast cancer and AIDS combined
• Recent estimates project that as many as 1 in 3 American adults will have diabetes in 2050 unless we take steps to Stop Diabetes www.stopdiabetes.com

Diabetes affects the body in many ways.  Uncontrolled glucose levels lead to poor eye site, poor kidney function, poor circulation and nerve damage (peripheral neuropathy).  Neuropathy is the #1 risk factor for developing a diabetic ulcer.  If not treated in a timely manner, this may lead to complications, including amputation.

If you suffer from diabetes, be sure to maintain tight glycemic control, inspect your feet daily, dry well in between your toes and avoid barefoot.

Please call 856-691-2152 to make a preferred appointment.  A comprehensive diabetic exam will be performed by one of our foot and ankle specialists.

 

 

Tags: ulcer, nerve damage, diabetes, Peripheral Neuropathy, poor circulation, American Diabetes Month, American Diabetes Association

People with diabetes are prone to foot problems because the disease can cause damage to the blood vessels and nerves, which may result in decreased ability to sense a trauma to the foot. The circulation is also altered, so that the diabetic cannot efficiently fight infection.

 

 

MORE HELPFUL TIPS: Do NOT use antiseptic solutions on your feet because these can burn and injure skin.Do NOT apply a heating pad or hot water bottle to your feet. Avoid hot pavement or hot sandy beaches.Remove shoes and socks during visits to your health care provider. This is a reminder that you may need a foot exam.Do NOT treat corns or calluses yourself using over-the-counter remedies. Make an appointment with a podiatrist to treat foot problems.If obesity prevents you from being physically able to inspect your feet, ask a family member, neighbor, or visiting nurse to perform this important check.Report sores or other changes to your doctor immediately. Report all blisters, bruises, cuts, sores, or areas of redness.

Tags: infection, blood vessels, nerve damage, diabetes

A 29 yo California man is the fist person in Kern County to receive a bionic foot.  The Proprio Foot is an artifically intelligent and motor-powered prosthesis.

This prosthesis virtually eliminates limping, compensating, reduces fear of tripping and reduces pain associated with the physical demand placed on the knee, hip and back.

Other models are rigid and have a fixed ankle.  The bionic foot senses motion and is able to adapt to different ground surfaces.

Amputation can result from complications of diabetes, peripheral arterial disease (PAD), traumatic injury and congenital defects.

The bionic foot may be useful for military professionals returning from overseas who have suffered traumatic amputations.

Tags: amputation, below the knee amputation, peripheral arterial diease, diabetes, Proprio Foot, bionic foot

Two of the most common foot problems diabetics face are Neuropathy and Peripheral Arterial Disease.

Diabetic neuropathy, or nerve damage, is a result of uncontrolled diabetes.  Damaged nerves cause symptoms like burning, tingling and numbness.  If you have a lack of feeling in your feet you are more likely to develop a cut or sore.  The muscles in the feet maynot function well, as they are controlled by nerves.  This causes and shift in alignment and may create too much pressure in one area.

Peripheral Arterial Disease, or poor circulation can be caused by diabetes.  Without adequate blood flow, cuts and sores take longer to heal.  The longer a sore stays open, the greater the chance of infection with complications including gangrene and amputation.

10% OF PEOPLE WITH DIABETES WILL DEVELOP FOOT ULCERS

***If you have diabetes be sure to look at your feet daily and never walk barefoot!

If you have a history of diabetes please call Foot Care Centers at 856-691-2152 to make a preferred appointment.

Tags: poor circulation, peripheral arterial disease, ulcer, numbness, burning, tingling, neuropathy, diabetes