High Rate of Diabetes and Diabetic Related Foot Amputations

Monday, December 29, 2008: the Pittsburgh Post-Gazette reports on the high rate of diabetes and diabetic related foot amputations.

It has been reported that between 2003 and 2006, the national average diabetic amputations is 1.1 amputations per 1,000 per Medicare beneficiaries. By contrast, Pennsylvania has 1.23 lower-limb amputations per 1,000 Medicare beneficiaries. That is a rate that is about 38% higher than nearby state of Rhode Island and Michigan.

The newspaper article highlights a 77-year-old type 2 diabetic who ended up with partial foot amputation. The story explains that the gentleman had a bone spur and persistent diabetic foot ulcerations, which lead to an infection. Because of the spread of the infection, it was necessary to perform a partial foot amputation in an attempt to save his leg. He had been borderline diabetic for about 10 years prior to the amputation. Amputation was followed by a stay in a nursing home, where he received powerful antibiotics.

Unfortunately many Southern states actually have even worse rates of amputations than Pennsylvania. Geography is the not the only contributing factor. It was also reported that African-Americans nationwide have a risk that is about four times the amputation rate for Caucasians. The rate is actually nearly 7 times as bad if they live in Louisiana, South Carolina or Mississippi.

Poor diet and lack of exercise are all contributing factors to these sorts of complications related to diabetes. Patterns of diet and exercise appeared to have geographic correlation.

The Dartmouth Atlas also reveals that African-Americans nationwide have four times the amputation rate of whites, with nearly seven times the national average in portions of Louisiana, South Carolina and Mississippi. Texas actually has some of the highest rates of amputation with McAllen, Corpus Christi and Harlingon being the worst areas. These areas have imputation rates that are nearly twice the national average.

The diabetic foot partial amputee highlighted in this story credits his podiatrist with saving his legs so that he can still walk. Early detection with these sorts of complications is essential to preventing a worse amputation.

Is absolutely necessary for your doctor to check your at your visit, if you are a diabetic, any new open sore or concerning area on the foot must be checked immediately. We know that early intervention can prevent open sores, infections, and amputation related diabetes. It’s hard to believe, but true, that something as simple as ingrown toenail can lead to the sort of infection results in a diabetic amputation.

Lower limb amputations related to diabetes, are often the result of poor blood sugar control, diabetic foot neuropathy, and a compromised immune system. Unfortunately, these are not the only problems and develop diabetes. Many diabetics also develop heart disease, kidney disease and blindness.

Of all of these complications, diabetic foot ulcers, wounds, and other problems that can lead to gangrene and amputation may be the most preventable. Although there has been increasing awareness of the problems related to diabetic orders, it seems to be very slow progress in the area of actual prevention of these problems. Many new technologies do exist which can aid in the detection and early prevention of the open sores that the heat infections in amputations among diabetics.

The more traditional methods of preventing these problems include seeing a podiatrist to check the pulses in the feet in order to assess blood flow. If there is any compromise of the circulation referral to a vascular surgeon may be arranged. Often times blood flow to the feet and legs can be restored through stent placement or angioplasty. Sometimes a bypasses performed in order to restore blood flow to defeat. Checking for neuropathy, or diabetic nerve damage, is also important. Diabetic shoes are also helpful in reducing friction and shear forces to the feet that can lead to open sores.

Unfortunately, even these well-documented interventions are not available to everybody. It is well known that poverty and a lack of access to podiatrists and other healthcare practitioners can increase the rates of complications leading to diabetic foot amputation.

The worst part about all of this is that we know that once in amputation does occur, life expectancy and dropped to only about 18 months. This is often because of decreased mobility, increase risk of developing pneumonia and other health-related problems.

Source: http://www.post-gazette.com/pg/08364/938218-114.stm


Dr. Christopher Segler is an author, inventor and award winning diabetic foot specialist. He is the founder of a private consulting firm specializing in the prevention of diabetic foot amputations. If you or someone you care about has diabetes, you can learn more by simply requesting your FREE report “No Leg Left To Stand On: The Secrets Insurance Companies Don’t Want You To Know About Diabetic Foot Amputation” at http://www.ineedmyfeet.com.