Each year in the U.S. diabetes results in the amputation of about 65,700 legs or feet. About 85% of those began with a diabetic foot ulcer. And for Dr. David Schwegman, the mission to educate people about the issue is personal.
His father, a diabetic, had a foot ulcer that resulted in the amputation of his left leg, which contributed to his death, his son said.
"He became a statistic," Schwegman said. "He was one of the 50% of people that died within five years after having an amputation."
Diabetic foot ulcers, or DFUs, are usually located on the ball of the foot, the bottom of the big toe or sides of the feet. They can be a result of neuropathy, or nerve damage which leads to a loss of feeling.
Although prevention is key, simply not treating an ulcer can lead to infection, particularly in the bone, and eventual loss of a limb.
"If you have a DFU that leads to a major amputation, your risk of death in five years is greater is higher than that of breast cancer and prostate cancer combined," Schwegman said.
"This is a very, very serious health problem that has very serious risks if not dealt with properly and quickly," the doctor said. "In order to do that, we really need to get the word out to both the patients and the physicians."
That's where the Save a Leg, Save a Life Foundation , or SALSAL, comes in. On Saturday, Schwegman, along with the Atlanta chapter of the national group, are offering free foot screenings as part of the American Diabetes Association's Health Expo.
You can find an expo near you by visiting the American Diabetes Association's calendar for 2011. Diabetics can be screened for cuts, blisters, discoloration of feet, and any signs of bacteria or infections, conditions that can lead to foot ulcers.
Right now, 18.8 million adults and children in the U.S. have diabetes. The Centers for Disease Control and Prevention estimates that 7 million people have undiagnosed diabetes and 79 million are prediabetic.
Diabetics need to know that treating the ulcer early is the best way to get it healed.
"If we're not treating them aggressively, the chances that they heal is actually very, very low," Schwegman said.
An important part of the evaluation of a person with a diabetic foot ulcer is a thorough vascular exam, since diabetics have a higher risk of having peripheral arterial disease. The condition results when circulation to the legs and feet is blocked or narrowed by calcifications. The poor blood flow can cause pain and discoloration in the feet- an increase in a red color, a dusky bluish color or sometimes the toes turn black and result in amputation.
Dr. Desmond Bell, a wound care specialist and founder of SALSAL, recommends going straight to a podiatrist or wound care specialist if a cut, sore or wound does not heal in a week or two. Those with a history of diabetic foot ulcers should see a specialist immediately.
Bell said several newer treatments are available to treat these wounds. None are a "silver bullet" for every single wound.
SALSAL hopes to educate both physicians and the general public about them in order to prevent unnecessary amputations. Of the thousands of products available, only these three have evidence that they have increased wound healing rates:
-Advanced skin cell substitutes include Dermagraft and Apligraf. These are similar in that they are derived from neonatal foreskins.
-A growth factor gel, Regranex.
Hyperbaric oxygen therapy can also heal wounds and treat infections.
Most exciting, Bell said, is peripheral revascularization, in which cardiologists and others, go into the groin similar to an angioplasty for the heart. Through this new procedure, doctors can open up blockages in the leg and restore blood flow.
"It requires lots of doctors often times and it requires a motivated patient," Schwegman said. "By saving their leg, it really does save their life."
Monday, May 2, 2011
Tuesday, April 5, 2011
Bunions more common in women
New research has found that an increase in the severity of bunions not only increased foot pain and impaired mobility, but also affected people's general health and quality of life.
Bunion deformity was found in 36% of the study sample. It occurred more frequently in women and older individuals. The study also found that pain in other parts of the body beyond the foot was associated with increased bunion severity.
Associate Professor Hylton Menz of La Trobe University in Melbourne, Australia, and colleagues at the Arthritis Research UK Primary Care Centre, Keele University examined the prevalence of and factors associated with hallux valgus – bunions.
The Medical Research Council funded study assessed the severity of deformity on general and foot-specific Health Related Quality of Life (HRQOL) of 2,831 people aged 56 years or older in North Staffordshire.
The research team established five severity grades of hallux valgus, corresponding to the angle of deformity - from 0, 15, 30, 45, and 60 degrees.
Results showed that the impact of increasing hallux valgus severity on HRQOL is independent of age, sex, education, body mass index, and pain in other parts of the body.
They also revealed that impact of bunion extends beyond pain and physical function to affect general health, vitality, social function, and mental health.
"Our findings indicate that hallux valgus is a significant and disabling musculoskeletal condition that affects overall quality of life," concluded Associate Professor Menz.
"Interventions to correct or slow the progression of the deformity offer patients beneficial outcomes beyond merely localised pain relief."
Hallux valgus is a common foot condition that is caused when the big toe bends in towards the smaller toes. It develops over time and is accompanied by a painful soft tissue and bony protrusion, known as a bunion.
As the deformity progresses the lateral displacement of the hallux (big toe) begins to interfere with normal alignment and function of the smaller toes, leading to further deformities such as hammer toe or claw toe, altered weight-bearing patterns, and the development of corns and calluses.
Family history, wearing high-heeled shoes or shoes that are too narrow, and flat footedness have all been suggested to contribute to the development of bunions.
Details of this UK population-based study appear in the March issue of Arthritis Care & Research, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology (ACR).
Monday, March 21, 2011
American Diabetes Association ALERT! DAY
Americans are urged to “Join the Million Challenge” on American Diabetes Association Alert DaySM by taking the Diabetes Risk Test and finding out if they are at risk for developing type 2 diabetes
Tuesday, March 22, 2011 is the 23rd annual American Diabetes Association Alert Day, a one-day, “wake-up” call asking Americans to “Join the Million Challenge” by taking the Diabetes Risk Test and find out if they are at risk for developing type 2 diabetes and if they are at high risk, to speak with their health care provider.
At the end of 2010, the American Diabetes Association surpassed their goal of inspiring one million Americans to join the American Diabetes Association’s movement to Stop Diabetes®. To continue this momentum, the Association is asking the public to “Join the Million Challenge” by rallying one million people to take the Diabetes Risk Test and find out if they are at risk for developing type 2 diabetes, beginning on Diabetes Alert Day on March 22, 2011 and ending April 22, 2011.
Diabetes is a devastating disease that affects nearly 26 million Americans including. A quarter of those affected by diabetes are not aware that they have the disease. If current trends continue, one in three American adults will have diabetes by 2050. In addition, approximately 79 million, or one in three American adults have prediabetes, which means that their blood glucose (sugar) is higher than normal but is not high enough to be classified as diabetes. Without intervention, individuals with prediabetes are at a much higher risk for developing type 2 diabetes. Seeking to change the future of diabetes, the American Diabetes Association is using Diabetes Alert Day to help identify the undiagnosed and those at risk for type 2 diabetes by educating people about diabetes risk factors and warning signs.
Unfortunately, people with type 2 diabetes can live for years without realizing that they have this serious disease. While some people with diabetes exhibit noticeable symptoms (such as frequent urination, blurred vision and excessive thirst), most people diagnosed with type 2 diabetes do not experience these overt warning signs at the time that they develop the disease. Often, type 2 diabetes only becomes evident when people develop one or more of its serious complications, such as heart disease, stroke, kidney disease, eye damage or nerve damage, which can lead to amputation.
2011 Diabetes Alert Day
“Studies have shown that type 2 diabetes can be prevented or delayed by losing just 7% of body weight (15 pounds if you weigh 200) through regular physical activity (30 minutes a day, five days a week) and healthy eating,” said Gina Perales Hethcock, Director of Communications and Hispanic Initiatives for the North Texas office. “The American Diabetes Association hopes that this American Diabetes Association Alert Day will encourage people to ‘Join the Million Challenge.’ By understanding your risk, you can take the necessary steps to help prevent the onset of type 2 diabetes.”
To help people determine their risk for type 2 diabetes, the American Diabetes Association provides the Diabetes Risk Test, which entails answering simple questions about weight, age, family history and other potential risk factors for diabetes. People at high risk are encouraged to speak with their health care providers. You can “Join the Million Challenge” by getting your free Diabetes Risk Test (English or Spanish) at www.stopdiabetes.com, 1-800-DIABETES (1-800-342-2383) or text JOIN to 69866 (Standard data and message rates apply). Although Diabetes Alert Day is a one-day event, the Diabetes Risk Test is available year round.
The Association is also encouraging the public to help spread the word about Diabetes Alert Day by sending out messages on Facebook and Twitter. You can download a Diabetes Alert Day application to post on your Facebook page or you can tweet about the importance of understanding one’s risk for type 2 diabetes and provide a link to the Diabetes Risk Test at stopdiabetes.com.
The primary risk factors for type 2 diabetes are being overweight, sedentary, over the age of 45 and having a family history of diabetes. African Americans, Hispanics/Latinos, Native Americans, Asian Americans and Pacific Islanders are at increased risk, as are women who have had babies weighing more than nine pounds at birth.
'Diabetes belt' emerges in Southeast U.S.
Individuals who live in one of several Southern states are significantly more likely to receive a positive HbA1c test for diabetes, as a new study from the Centers for Disease Control and Prevention has identified what officials are calling the "diabetes belt" of the U.S.
The belt stretches from Pennsylvania in the Northeast to Texas in the Southwest and includes all the states in between. The rate of diabetes in these states is 11 percent, compared to a national rate of 8 percent.
The researchers said that obesity and sedentary lifestyles were most likely the causes of this discrepancy. Nearly 33 percent of people from these states are obese, while the national average is 26 percent. More than 30 percent are largely sedentary, compared to a national rate of 24.8.
Identifying areas where prevalence of the disease is highest could allow public health officials to direct their resources more efficiently and hopefully contain diabetes, the researchers said.
"Identifying a diabetes belt by counties allows community leaders to identify regions most in need of efforts to prevent type 2 diabetes and to manage existing cases of the disease," said Lawrence E. Barker, who led the study. "Although many risk factors for type 2 diabetes can't be changed, others can."
The belt stretches from Pennsylvania in the Northeast to Texas in the Southwest and includes all the states in between. The rate of diabetes in these states is 11 percent, compared to a national rate of 8 percent.
The researchers said that obesity and sedentary lifestyles were most likely the causes of this discrepancy. Nearly 33 percent of people from these states are obese, while the national average is 26 percent. More than 30 percent are largely sedentary, compared to a national rate of 24.8.
Identifying areas where prevalence of the disease is highest could allow public health officials to direct their resources more efficiently and hopefully contain diabetes, the researchers said.
"Identifying a diabetes belt by counties allows community leaders to identify regions most in need of efforts to prevent type 2 diabetes and to manage existing cases of the disease," said Lawrence E. Barker, who led the study. "Although many risk factors for type 2 diabetes can't be changed, others can."
Wednesday, March 9, 2011
Why Does My Big Toe Joint Hurt Part 3
Well folks, its official....I had my first pain free run in months! I was about a mile into my run yesterday and I thought to myself, "Wow my toe doesnt hurt a bit!" I ran 3 10 minute miles and my toe is not sore at all today. Other parts of my body...well that is a different story. Dr. Gordon is truly special and has helped me a lot. I am a firm believer of orthotics now. Also I have noticed that when I walk up stairs the cracking and popping in my knees has decreased dramatically! Im only 30 so that is a GREAT thing.
Today I developed blisters on my heels from my stupid dress shoes. I put my orthotics in them but I didnt take the shoe inserts out. I think that may be the trick. My shoes were rubbing too high on my heels. But...my toe still doesnt hurt so that is a big plus. Its all trial and error. Who knows maybe I will get my husband to dish out some cash for better dress shoes that my orthotics fit nicely in. Its a medical necessity right????!!!!
Today I developed blisters on my heels from my stupid dress shoes. I put my orthotics in them but I didnt take the shoe inserts out. I think that may be the trick. My shoes were rubbing too high on my heels. But...my toe still doesnt hurt so that is a big plus. Its all trial and error. Who knows maybe I will get my husband to dish out some cash for better dress shoes that my orthotics fit nicely in. Its a medical necessity right????!!!!
Paramedic took severed foot from car crash victim... to use it to train her dog
By Daily Mail Reporter
Last updated at 11:19 PM on 8th March 2011
A former paramedic who admitted to taking a man's severed foot from the scene of a crash is now being sued for going 'beyond the bounds of decency'.
Cynthia Economou, a former fire-fighter-paramedic from Florida, admitted to taking Karl Lambert's foot in September 2008 to use as a training aid for her body recovery dog.
But now Mr Lambert is seeking unspecified damages in a lawsuit issued last week.
Enlarge Sued: Cynthia Economu is now being sued for taking a foot she found in a car wreck in 2008. She said the foot was used to train her cadaver dog
The lawsuit lists the taking of the foot as: 'Outrageous and went beyond the bounds of decency...was odious and utterly intolerable in a civilized society.'
Economou was originally sentenced to six months probation in 2009 for second-degree petty theft.
At the time, she told a court the foot was unusable when she found it at the crash scene an hour after Mr Lambert was airlifted to hospital.
She said: 'It was an unrecognisable mass of flesh.
'It wasn't a clean cut. You couldn't even recognise it as a foot....If I had thought it was somehow re attachable and usable, I would have gone to my commander.'
The lawsuit, however, contends that Economou: 'Removed the leg rather than delivering it to the hospital where it could have been reattached.'
At the time of her 2009 arrest, police records show the foot was valued at less than $100.
At the time it was alleged that Economu brought the amputated foot to a fire station before a family member brought it home to use for training her cadaver dog.
Body recovery or 'cadaver' rescue dogs help search teams find dead bodies in murder or disaster recovery situations.
They are trained to sniff out decaying of putrefied human remains in a range of climates, including freezing water.
Crash: This is the car crash where the foot was found by Miss Economu in 2008
Speaking to website TCpalm at the time she said: 'This is just so unbelievable, it’s like a dream I’m in.
'I can’t believe it’s happening.'Economou left her paramedic job after the incident came to light.
Mr Lambert had to have his leg amputated roughly five inches below the knee after the accident.
She was sentenced to six months probation, but was not formally convicted of the crime.
In 2007 Economou was named St Lucie County fire fighter of the year.
Last updated at 11:19 PM on 8th March 2011
A former paramedic who admitted to taking a man's severed foot from the scene of a crash is now being sued for going 'beyond the bounds of decency'.
Cynthia Economou, a former fire-fighter-paramedic from Florida, admitted to taking Karl Lambert's foot in September 2008 to use as a training aid for her body recovery dog.
But now Mr Lambert is seeking unspecified damages in a lawsuit issued last week.
Enlarge Sued: Cynthia Economu is now being sued for taking a foot she found in a car wreck in 2008. She said the foot was used to train her cadaver dog
The lawsuit lists the taking of the foot as: 'Outrageous and went beyond the bounds of decency...was odious and utterly intolerable in a civilized society.'
Economou was originally sentenced to six months probation in 2009 for second-degree petty theft.
At the time, she told a court the foot was unusable when she found it at the crash scene an hour after Mr Lambert was airlifted to hospital.
She said: 'It was an unrecognisable mass of flesh.
'It wasn't a clean cut. You couldn't even recognise it as a foot....If I had thought it was somehow re attachable and usable, I would have gone to my commander.'
The lawsuit, however, contends that Economou: 'Removed the leg rather than delivering it to the hospital where it could have been reattached.'
At the time of her 2009 arrest, police records show the foot was valued at less than $100.
At the time it was alleged that Economu brought the amputated foot to a fire station before a family member brought it home to use for training her cadaver dog.
Body recovery or 'cadaver' rescue dogs help search teams find dead bodies in murder or disaster recovery situations.
They are trained to sniff out decaying of putrefied human remains in a range of climates, including freezing water.
Crash: This is the car crash where the foot was found by Miss Economu in 2008
Speaking to website TCpalm at the time she said: 'This is just so unbelievable, it’s like a dream I’m in.
'I can’t believe it’s happening.'Economou left her paramedic job after the incident came to light.
Mr Lambert had to have his leg amputated roughly five inches below the knee after the accident.
She was sentenced to six months probation, but was not formally convicted of the crime.
In 2007 Economou was named St Lucie County fire fighter of the year.
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