Gene Therapy may be the Future in Amputation Prevention in Diabetics with Poor Blood Flow

Cardiologists and vascular surgeons at Rush University Medical Center are now studying in innovative but investigational new medication that involves gene therapy. Researchers are working to determine whether or not gene therapy can promote new blood vessel growth in the feet and legs of patients who suffer from critical limb ischemia.

Critical limb ischemia is a condition that results in a severe lack of blood flow to the patient’s feet and legs. This often occurs in patients with diabetes. Peripheral vascular disease and disruptions in blood flow to the feet and legs are a major cause of amputation in the United States. At present, about 70% of all amputations are related to diabetes.

When a patient has diabetes, the process of atherosclerosis which clogs the arteries happens faster. If this process goes on for long enough, critical limb ischemia can develop. Because the arteries become clogged, there is less circulation to the feet and legs.

This results in a lack of oxygen and, in a sense, starves the tissues of nutrients. Without nutrients, the tissue start to die off and ulcers (or diabetic foot sores)can develop. “The goal of gene therapy is to stimulate the growth of new blood vessels. The additional blood vessels will carry more blood into the legs, alleviating pain and healing ulcers,” one of the researchers said.

The research is presently being done at Rush University involves Phase III clinical trials which will evaluate the effectiveness of gene therapy in preventing amputations in people with critical limb ischemia.

At present there are no prescription drugs at all available which can effectively treat critical limb ischemia. Because there are so few interventions that are effective, new therapies are needed in order to prevent the sorts of amputations.

This type of gene therapy is known as angiogenesis therapy, which means growth of new blood vessels. This sort of gene therapy appears to induce the production of a protein called fibroblast growth factor (FGF-1) which stimulates the growth of blood vessels at the site of injection.

The clinical trials that are now under way will last for one year. Participants are over 50 years of age, have stable ulcerations of the skin and noninfected gangrene on a foot or leg. All have also been diagnosed with peripheral arterial disease and critical limb ischemia. The participants will receive for injections of the investigational medication or a placebo into the leg muscle a two week intervals.

It is known that about 8 million people suffer from peripheral arterial disease. In the United States, that means one out of every 40 adults. It is a very common disease. It is often underdiagnosed. Because it is so common in diabetic patients, this might provide new hope for the prevention of diabetic foot amputations.


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.

Statistics on Life Expectancy After Diabetes Leg Amputation from Gangrene

One question I was asked recently is was... What are the statistics on life expectancy after diabetes leg amputation from gangrene?

Well, I wish I had good news. Whenever a loved one gets gangrene, it can be traumatic. Not just for the diabetic who winds up with an amputation, but the spouse as well. The kids, the whole family take a beating emotionally. They see the foot turn black, they smell the foul odor. They watch their loved one go from a lively person to someone who will be luckey to ever walk with a prosthetic leg.

Dancing on your 50th wedding anniversary..nope. Going for 18 holes of golf..nope. Running down the street to teach your grandson to fly a kite...nope. So the patient sees all these things that were taken for granted, drifting away. And the family sees it too. Then they start to wonder about the bigger picture. How long can you live after an amputation?

The statistics regarding diabetic life expectancy after an amputation related to diabetes complications (such as gangrene, diabetic foot infections, and bone infections (osteomyelitis)) are quite bad. Every 30 seconds a limb somewhere is amputated as a consequence of diabetes.

In fact, we know that diabetes makes you 46 times more likely you will have an amputation. Within one year after a diabetic foot amputation, 26.7% will have another amputation. Three years after the first diabetic amputation, 48.3% will have another amputation. Within 5 years of a diabetes related amputation, 60.7% will have another amputation.

If that isn't bad enough, diabetics with amputations don’t live very long. We know that about 50% of all diabetics with an amputation are dead 3 years after the amputation.

65% of all of those with a diabetic amputation are dead 5 years.

In spite of this, there is hope... most are preventable. Watch your blood sugar. Check your feet every day and see a podiatrist, podiatric surgeon, or foot surgeon specializing in diabetic limb salvage if you start to get any open sore or wounds on your feet. Do not wait until it is infected.

With these simple interventions you can keep your feet. And maybe you will dancing on your 50th after all.


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.