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Diabetes and Danger: The Amputation Factor

February 5, 2009 By:
Rita Charleston, JE Feature
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One of the most frightening risks those with diabetes must face is having a limb or appendage amputated. In fact, according to a recent study by the American Podiatric Medical Association, 25 percent of amputees with diabetes stated that they should have seen a specialist, such as a podiatrist, sooner than they had once their symptoms arose.

"Today, diabetes is on the rise, and so having to endure these amputations is becoming all too common," says Ira Meyers, doctor of podiatric medicine, who, in practice with his wife, Theresa Tobin, is associated with several area hospitals.

Statistics say that diabetic amputation is beginning to reach epidemic proportions, with the number of Americans being diagnosed with diabetes increasing five times within the last three decades.

Statistics in a recent Dartmouth University study showed that one in every 1,000 Medicare beneficiaries in Philadelphia alone received a lower-limb amputation due to diabetic complications. And the APMA says that close to 24 million people in the United States have diabetes, and nearly 6 million people have it and don't even know it.

Meyers insists that almost everyone knows someone who has had an amputation due to the disease. But one of his patients was fortunate enough to defy the odds and just barely miss having to undergo an amputation.

"She is an insulin-dependent diabetic, meaning her disease is a little more advanced. Over time, her foot was becoming numb and painful at the same time. That often happens when patients develop what is called an ulcer, or a break in the skin, with the skin being one of the best organs in the body for preventing infection.

"But when the foot becomes infected and changes," he adds, "diabetics cannot notice problems with their feet, and she was no exception. She was oblivious to any change taking place. Luckily, however, she came to us in time; we treated her successfully and were able to save her feet."

Ways of Prevention
Meyers says that, in dealing with diabetes, many people know that it can cause kidney failure, but few realize that the disease can, and often does, cause amputation.

But many more people with diabetes could be spared the procedure if they only knew about taking preventative measures, believes Meyers.

First of all, he agrees with advice from the APMA, which encourages those with diabetes or those at risk to have their feet examined by a podiatrist every year to avoid possible complications, such as amputation.

"In the beginning, there often are no warning signs," explains Meyers, "which is why we recommend having at least a yearly visit with a podiatrist, especially for those over 40. When a new patient comes in to see us, we check the circulation for pulses in the foot, any skin changes, and poke around the foot to see if there is feeling. But most importantly, patients must learn to educate themselves."

Of course, one of the best methods of education is making people realize that, if they are not born with the disease, how bad eating habits and unhealthy lifestyles can contribute to getting it.

A checklist for helping to prevent diabetes from going further includes inspecting and washing feet daily, and always drying carefully between the toes. Also, people should cut toenails straight across, wear loose-fitting socks to bed if feet are cold and always wear comfortable shoes.

Some of the "don'ts," points out Meyers, include "never walking barefoot -- even indoors -- not smoking and not wearing open-toed shoes."

For more information, visit: www.APMA.org.

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