Diabetes, once diagnosed, is present for life. Diabetes Mellitus is a metabolic disease characterized by elevated glucose (blood sugar), resulting from defects in secretion of the hormone insulin, defects which cause the tissue to resist absorption of insulin or both.
Chronic elevation of blood sugar (hyperglycemia) is associated with long-term damage to the eyes, heart, kidneys, feet, nerves, and blood vessels. About 15 percent of those with diabetes will develop an open wound (ulceration) on a foot during their lifetimes, and 20 percent of these ulcerations will lead to amputations. The annual incidence of non-traumatic lower extremity amputations among people with diabetes is about 54,000, according to the American Diabetes Association.
Among African-Americans, the amputation rate is 1 1/2 to 2 1/2 times that of Caucasians, and Native Americans have even higher rates, three or four times that of Caucasians. Diabetes, once diagnosed, is present for life. Considerable research is focused on finding a cure, and much progress has been made in treatment and control of the disease.
What is type II Diabetes
The majority of people with diabetes have type II diabetes. Type II, non-insulin-dependent diabetes mellitus, once known as adult-onset diabetes, afflicts the other 90-95 percent, many of whom use oral medication or injectable insulin. The vast majority of those people (80% or more) are overweight, many of them obese. Obesity itself can cause insulin resistance. The socioeconomic costs of diabetes are enormous. The dollar costs have been estimated at $92 billion annually, about equally split between direct medical costs and indirect costs. Diabetes is the fourth leading cause of death by disease in the United States. Individuals with diabetes are two to four times as likely to experience heart disease and stroke. It is the leading cause of end-stage kidney disease and new cases of blindness among adults under 75. The trauma of amputation is particularly debilitating. It often ends working careers, and restricts social life and the independence which mobility affords. For more than 50 percent of those who experience an amputation of one limb, the loss of another will occur within three to five years. The key to amputation prevention is early recognition and foot screening, at least annually, of at-risk individuals.
What does it mean to be high-risk?
Those individuals considered to be at high risk are those who exhibit one or more of six characteristics: (1) peripheral neuropathy, a nerve disorder generally characterized by loss of protective sensation and/or tingling and numbness in the feet; (2) vascular insufficiency, a circulatory disorder which inhibits blood flow to the extremities; (3) foot deformities, such as hammertoes; (4) stiff joints; (5) calluses on the soles of the feet; and (6) a history of open sores on the feet (ulcerations) or a previous lower extremity amputation.
What is ulceration? Am I at risk?
Ulceration is a common occurrence of the diabetic foot. Poorly fitted shoes, or something as seemingly trivial as a stocking seam, can create a wound that cannot be felt and may not immediately be seen by someone whose level of skin sensation has been minimized. Left unattended, such an ulcer can quickly become infected and lead to serious consequences. Visit a Podiatric Physician regularly.