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.

National Health Service Increases Funding for Diabetic Foot Programs Related to Podiatry

Children with diabetes in certain areas of the United Kingdom will be getting extra financial support.

The National Health Service has recognized the critical nature of funding diabetic programs for children. His most recent funding will help to pay for pediatric diabetic nurses as well as psychological support for children with type 1 diabetes. It is known that type 1 diabetes in children is linked with high levels of depression as well as eating disorders.

In addition to counselors who specialize in diabetes related to children and pregnancy, extra podiatrists have been added as well. For many years podiatrists in the United Kingdom have been recognized as critically important to preventing complications lead amputation. They have recognized that intensive monitoring by foot and ankle specialists, particularly podiatry, lead to early interventions and help to provide rapid treatment for diabetic foot ulcerations and open sores that can lead to amputation.

It has long been known that open sores in diabetic patients can rapidly become infected and lead to gangrene. Is also known that bone infections known as osteomyelitis are typically preceded by diabetic foot ulcers.

The hope of the additional funding is that diabetic patients will taking off of waiting lists and will be able to be evaluated sooner.

In addition to funding for type 1 diabetic patients, there’s a great need to assist with those with type 2 diabetes. Type 2 diabetes is becoming increasingly common. This rising type 2 diabetes, directly correlates with the increase in obesity within any given population.

At present, approximately 10% of the entire National Health Service annual budget is spent on treating diabetic foot ulcers, open sores on the feet, diabetic foot infections, and other diabetic foot complications.

Is well known that by having patient work closely with their primary care doctors and podiatrists, it is easier to keep diabetes under control and prevent diabetic foot amputations. It is also important to make sure that they podiatrist is closely involved one of diabetic patient begins a new program of exercise to help control the persons blood sugar.

Diabetes is not have to lead to amputation. With good blood sugar control, proper diet and exercise, diabetic patients can hope to lead a healthy and active life.



Dr. Christopher Segler is an award winning diabetic foot surgeon, author and inventor. He is the founder of a groundbreaking private consulting firm that specializes in diabetic amputation prevention. 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.

How Can Becoming an Athlete Prevent a Diabetic Foot Amputation?

One of the very best ways to treat diabetes is with exercise. We know that when a patient has diabetes, diet and exercise can significantly change the course of the disease. In fact, we know that after 45 minutes of aerobic exercise, such as running, a diabetic patient’s insulin sensitivity may increase for up to 48 hours. This is extremely beneficial for type 2 diabetics.

Not only can exercise such as running help a diabetic patient by changing the way that the body can use insulin, it also can help a number of other conditions.

We know that in all people, exercise can dramatically affect cholesterol levels. Hyperlipidemia or high cholesterol is one common condition affecting diabetic patients. We know that the VLDL and LDL (bad cholesterol) is lowered with exercise, while HDL (good cholesterol) is increased.

In addition, regular exercise can significantly affect a person’s blood pressure. Hypertension or high blood pressure is a common complication of diabetes. We know that regular exercise can typically reduce blood pressure by an average of 10 mm/Hg.

Obesity is another problem that is commonly associated with diabetes. Obesity alone is a major cardiovascular risk factor. It also leads to insulin resistance, further complicating diabetes. When a diabetic patient loses at least 15 to 20 pounds, fasting insulin levels can drop by 30 to 50%. As a result, there is much better blood glucose control.

Heart attacks and strokes are very common in type 2 diabetic patients. Regular aerobic activity such as walking and running have been shown to reverse the effects of increased levels of an enzyme called plasminogen activator inhibitor-1, which can in turn significantly reduce the risk of heart attack and stroke.

All of the disease processes mentioned can help clog the arteries and decrease blood flow to the legs. When this happens, you can get an open sore... it doesn't heal... it gets infected... and then you get gangrene. Once you get a diabetic foot infection with gangrene of the foot you will either get an amputation or you will die. But not to worry... it is all preventable!

With all of these possible benefits of exercise, it is understandable why any diabetic patient would (and should) embark on a program of exercise. The whole emphasis with diabetes is preventing long-term complications. Train Smart...Live Long!



Dr. Christopher Segler is an award winning diabetic foot surgeon, author and inventor. He is the founder of a groundbreaking private consulting firm that specializes in diabetic amputation prevention. 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://ineedmyfeet.com.

Is Diabetes a Handicap?

Although diabetes is a serious disease, it should only be considered a handicap when it limits the activities that allow you to enjoy life. One obvious way this can happen is through an amputation or blindness. But it doesn’t have to be this way.

Although we know that diabetes can lead to heart disease, stroke, blindness and open sores on the feet that lead to amputation or death, this is largely preventable.

Research shows that regular exercise and a healthy diet are two ways that can help people prevent diabetes, or even to alter the course of a person’s disease if they do already do have diabetes.

One of the very best ways to make sure the diabetes does not become a handicap is with exercise. We know that when a patient has diabetes, diet and exercise can significantly change the way your body uses insulin and help fight the disease. In fact, we know that after 45 minutes of aerobic exercise, such as running, a diabetic patient’s, insulin sensitivity may increase for up to 48 hours. This is extremely beneficial for type 2 diabetics.

Exercise not only changes the way that your body uses insulin, but it can reduce problems associated with cholesterol, blood pressure, risk of a heart attack or stroke and obesity. We know that when a diabetic patient will lose 15 to 20 pounds, it improves insulin levels from anywhere to 30 to 50%. This results in much better blood sugar control that can prevent many of the complications from diabetes that we worry about.

In United States diabetes is the fifth deadliest disease. We actually think it might be much worse than this because people who do have diabetes might die from other complications including heart attack, stroke or complications of an amputation with gangrene related to a diabetic foot sore.

Whether you are a type 1 or type 2 diabetic patient, exercise can provide a tremendous benefit. You just have to be careful and make sure that you manage your blood sugar correctly.

Oral hypoglycemic medicines ( pills to keep your blood sugar down) may also have a significant impact on your blood sugar when you exercise. For example, sulfonylureas (glipizide, glyburide, etc.) and meglitinides (prandin, starlix, etc.) may require dosing adjustments in order to prevent hypoglycemia (low blood sugar) during exercise. Metformin (glucophage) and thiazolinediones (actos and avandia) are less likely to cause hypoglycemia when you exercise. However if you are taking any of these medicines it is important to talk to your endocrinologist or primary care physician to make sure that you don’t get into trouble.

You should also make sure that you get checked by a podiatrist to make sure that you do not have any problems with your feet, such as diabetic peripheral neuropathy ( loss of feeling) that can put your risk of developing the kind of open sore that can lead to an amputation. An annual diabetic foot exam with a podiatrist is a good way to make sure that you are not at risk of an amputation.

And amputation is one sure way they diabetes can become a handicap. Once a leg is amputated, it’s very difficult to move around the home. Even something as simple as turning on a ceiling fan can become a major challenge. We also know that there are a number of risks associated with having an amputation. About half of all patients who have an amputation on one foot will have any vacation on the other leg within five years.

We also know that diabetic patients who have indications on both feet will most often die within five years.

In spite of all this gloom and doom, there is hope for diabetes. There are a number of available technologies which can significantly reduce the risk of amputation of diabetes. This requires intensive intervention from a specialist in diabetic limb preservation. Unfortunately, not covered by insurance, but is essential to making sure that in amputation is prevented.

Although it can be frustrating when you find out you have diabetes, it does not have to be a negative life altering situation. They can be a very positive thing because many of these people will start a new exercise routine, lose weight, and develop a healthy lifestyle that includes athletic activities that they might find intensely enjoyable.

For many of these people, what started out as a bad thing turns into a way to begin to enjoy life. So if you have been diagnosed with diabetes, don’t worry, it doesn’t have to become a handicap.

Dr. Christopher Segler believes diabetic amputations are preventable. He teaches strategies that help his clients avoid amputation. He is also and award-winning diabetic foot surgeon, inventor and author. If you have diabetes, you can learn how to avoid amputation by more by 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://ineedmyfeet.com.