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Why Do People With Diabetes Lose Their Legs?

Foot Infection: The Diabetes Complication That Kills More People Than Most Cancers

Foot Infection: The Diabetes Complication That Kills More People Than Most Cancers

A foot or leg amputation is one of the most dreaded complications of diabetes. In the US, more than 65,000 such amputations occur each year. But the tragedy does not stop there. According to recent research, about half of all people who have a foot amputation die within five years of the surgery—a worse mortality rate than most cancers. That’s partly because diabetic patients who have amputations often have poorer glycemic control and more complications such as kidney disease. Amputation also can lead to increased pressure on the remaining limb and the possibility of new ulcers and infections. Latest development: To combat the increasingly widespread problem of foot infections and amputations, new guidelines for the diagnosis and treatment of diabetic foot infections have been created by the Infectious Diseases Society of America (IDSA). What you need to know… Diabetes can lead to foot infections in two main ways—peripheral neuropathy (nerve damage that can cause loss of sensation in the feet)…and ischemia (inadequate blood flow). To understand why these conditions can be so dangerous, think back to the last time you had a pebble inside your shoe. How long did it take before the irritation became unbearable? Individuals with peripheral neuropathy and ischemia usually don’t feel any pain in their feet. Without pain, the pebble will stay in the shoe and eventually cause a sore on the sole of the foot. Similarly, people with diabetes will not feel the rub of an ill-fitting shoe or the pressure of standing on one foot too long, so they are at risk of developing pressure sores or blisters. These small wounds can lead to big trouble. About 25% of people with diabetes will develop a foot ulcer—ranging from mild to severe—at some point in their lives. Any ulcer, Continue reading >>

Diabetes Drug Gets Fda Warning Due To Amputation Risk

Diabetes Drug Gets Fda Warning Due To Amputation Risk

HealthDay Reporter WEDNESDAY, May 17, 2017 (HealthDay News) -- The type 2 diabetes prescription drug canagliflozin (brand names Invokana, Invokamet, Invokamet XR) appears to increase the risk of leg and foot amputations, the U.S. Food and Drug Administration says. The FDA is requiring the medications to carry new warnings about the risk. The required warnings on the drug's labeling include the most serious and prominent boxed warning. The agency's decision is based on data from two large clinical trials showing that leg and foot amputations occurred about twice as often in patients taking canagliflozin as among those taking a placebo. Amputations of the toe and middle of the foot were the most common, but leg amputations below and above the knee also occurred. Some patients had more than one amputation, some had amputations involving both limbs, according to the FDA. Type 2 diabetes occurs when the body becomes resistant to insulin. Insulin is a hormone that helps to usher sugar from foods into the body's cells. When this process doesn't work correctly, blood sugar levels rise. Left untreated, high blood sugar levels can cause a number of possible complications, including heart disease, kidney problems and amputations, according to the American Diabetes Association. Canagliflozin is meant to be used with diet and exercise to lower blood sugar in adults with type 2 diabetes. It belongs to a class of drugs called sodium-glucose cotransporter-2 (SGLT2) inhibitors. These drugs lower blood sugar levels by causing the kidneys to remove sugar from the body through the urine. It is available as a single-ingredient product under the brand name Invokana and also in combination with the diabetes medicine metformin under the brand name Invokamet. Patients taking canagliflozin shoul Continue reading >>

Common Diabetes Foot Problems And How To Prevent Them

Common Diabetes Foot Problems And How To Prevent Them

Foot problems in diabetes can be caused by damage to both large and small blood vessels, which is much more common in diabetes. Foot problems, including nerve damage or peripheral neuropathy, usually begin with vascular disease. Damage to small blood vessels, in particular, appears to be the major cause of nerve damage that results in loss of feeling, or worse pain and burning sensations that bother the feel and legs. Once nerve damage progresses, it triggers loss of motor control and the abnormal gait that results in ulcers and amputations. Preventing foot problems in diabetes begins by preventing the loss of circulation that will result in serious nerve damage. This is relatively easy today if the risks for circulatory problems are recognized early. Keeping the blood pressure below 130/80 is essential for reducing damage to blood vessel walls. Preventing placque formation is also critical. This is done with medications the lower triglycerides and raise HDL, such as gemfibrozil and niacin, and those that lower LDL and make it lighter, such as the statins. Blood vessels walls can also be protected with certain blood pressure meds called ACE inhibitors. Blood flow may be improved with high dose vitamin E, although 1200 mg to 1500 mg a day are usually required for this effect. absence of foot pulses a pale color of the foot when it is raised feet that feel cold pain at rest pain at night relieved by hanging the feet over the side of the bed thin appearing skin loss hair from the toes and feet shiny skin a blue color of the toes reddish color of the feet ulcers that don't heal a foot infection that is hard to heal Although amputations are 15 times as common with diabetes, about half can be prevented with simple steps that protect the feet: Unfortunately, about 60 to 70 per Continue reading >>

Diabetes: Protect Your Feet And Legs

Diabetes: Protect Your Feet And Legs

If you have diabetes, you are more likely than people without this disorder to develop leg and foot problems. Diabetes can destroy nerves and cause you to have poor circulation. Left unchecked, these complications can lead to amputation. But there's a lot you can do to prevent that from happening. How Diabetes Causes Limb Problems First, it's important to understand what causes these diabetes complications. According to Marilyn Tan, MD, an endocrinologist and the clinic chief of the Stanford Endocrine Clinic in California, risk factors include poor circulation from atherosclerotic peripheral arterial disease, poor wound healing, and uncontrolled blood sugar increases, which increases the risk of infection. “Think of sugar as fuel for bacteria and fungus,” says Dr. Tan. Researchers also know that high blood glucose levels can cause nerve damage called diabetic neuropathy. The damage can occur in any part of your body, but it is most common in your arms and legs, with the lower extremities affected first. This type of nerve damage is known as peripheral neuropathy. Some people have no symptoms, while others experience numbness, tingling, burning, sharp pain, cramps, extreme sensitivity when touched, and a loss of coordination and balance. When you have peripheral neuropathy, small sores can go unnoticed because of the numbness — you simply don’t feel them. Left untreated, these little problems can become major infections that invade the bones. What’s more, poor circulation from diabetes means any ulcers and infections are harder to heal. If an infection invades your bones, then amputation could be required to save your life. “Diabetes is the leading cause of nontraumatic lower extremity (leg and foot) amputations in the United States,” says Tan. “Five perc Continue reading >>

How People With Diabetes Develop Sores On Legs?

How People With Diabetes Develop Sores On Legs?

One of the greatest fears for diabetic people is to develop sores on their legs and feet. If you have these sores, it means your blood sugar levels are uncontrollably high and you need immediate medical attention. But what causes these sores? Let’s find out! Sores on legs for diabetics are caused by to two main things: 1. Damage to blood vessels: When you have diabetes, it means your blood glucose levels are higher than they should be. This has a lot of ill effects on your body and one of the effects is cell damage. High blood sugar damages your cells in two ways. First, high blood sugar sucks water out of your cells and damages them. Second, high blood sugar acts as a toxin for your cells and damages them directly. Almost all cells of the body can suffer some degree of damage due to high blood glucose, and cells of the bodies blood vessels are no exception. The blood vessels are like pipes that transport blood to your body cells. When the cells of your blood vessels are damaged they start to swell up. This distorts their architecture and they fail to deliver blood to your body parts. Your body cells need to get a constant supply of blood to survive. That’s because blood gives your cells oxygen, glucose and other nutrients 2. Due to damage to the bodies nerves: Your body nerves serve as a source of communication between your body parts and your brain. When a part of your body gets injured, the nerves in that area get injured too. These injured nerves then signal the brain that your body has suffered some injury and you should take care of it. But in diabetes, your nerves lose their ability to communicate with your brain. They just don’t work the way they should. As a result, when you suffer some injury or a small wound, it goes unnoticed. An unnoticed wound then g Continue reading >>

How Diabetes Affects The Feet

How Diabetes Affects The Feet

There's no sense in pussyfooting around: Diabetes poses a serious danger to your dogs. Having the condition doubles the risk for foot disease. In fact, about 30 percent of people with diabetes who are older than 40 develop medical problems with their feet. The damaged nerves and poor blood circulation that often accompany elevated blood sugar ensure that there is no such thing as a minor cut, scrape, bump, or bruise on the foot when you have diabetes. While blood-sugar problems can create a dizzying range of hard-to-treat complications, lower-limb diseases that are not properly treated can deteriorate so quickly and so badly that doctors have no other choice but to eliminate the problem altogether. That's another way of saying that people with diabetes account for 60 percent of all lower-limb amputations in the United States. In fact, a patient with diabetes is 10 to 30 times more likely to have a lower limb amputated than a person without the disease. The Feet For two sturdy performers who take a daily pounding, the feet are surprisingly complex structures. Combined, your two feet have more than one-quarter of the bones in your body -- 26 each. Although they form the foundation for the body, the feet aren't static blocks but agile and dynamic machines of movement, with more than 100 tendons, muscles, and ligaments apiece. Given their workload and all those moving parts, it's not surprising that about 75 percent of Americans experience one foot condition or another in their lifetime, according to the American Podiatric Medical Association. (Podiatrists are foot doctors.) The Feet and Diabetes Chronically elevated glucose levels can damage the nervous system, the wiring that transmits signals from the brain throughout the body. The nervous system works the other way, too Continue reading >>

Why Do Diabetics Have Bad Circulation?

Why Do Diabetics Have Bad Circulation?

Around 21 million Americans have diabetes, the University of Rochester Medical Center reports. Diabetes, an increase in blood glucose in the blood, affects the circulatory system in a number of ways. Circulatory problems from diabetes can cause increased disability and potentially life-threatening complications. Circulation problems worsen if diabetics don’t maintain good control over their blood glucose levels. Video of the Day Diabetes features several factors that narrow the small, medium and large blood vessels in the body. Sugar-based complexes build up in the vessel walls in small blood vessels, decreasing blood flow through them. Atherosclerosis develops when excess fat in the blood builds up on the large blood vessel walls. Plaque, the substance that attaches to the walls, narrows the blood vessels and decreases blood flow through the arteries. In addition to narrowing of the blood vessels, diabetes increases inflammation within the blood vessels. Diabetics have twice the risk of heart attack or stroke from atherosclerosis, the University of Rochester Medical Center website reports. Peripheral artery disease often causes decreased blood flow to the legs and feet. Legs may not receive enough blood flow when you’re walking, a condition known as intermittent claudication. Atherosclerosis can cause peripheral artery disease, but also causes decreased blood flow to the heart and other parts of the body. Damage to the small blood vessels in the eye causes diabetic retinopathy, which can lead to significant vision loss and blindness over time. Kidney damage occurs commonly in diabetes from problems with the blood vessels and reduced blood flow. Symptoms of poor circulation can include pain when walking, chest pain during exertion, high blood pressure, infections in Continue reading >>

Diabetes-related Leg Cramps: How To Prevent And Treat

Diabetes-related Leg Cramps: How To Prevent And Treat

Being suddenly woken up by a painful knot in your calf—or frozen toes—isn't fun. Here's what diabetes has to do with it and what you do to stop the pain. Perhaps you’ve been there—in the middle of a perfectly restful night of sleep you are abruptly woken up by an intense pain from a cramping muscle, typically in your foot or calf. Although the exact cause of muscle cramps is still up for debate, they are frequently linked to poor flexibility and muscle fatigue. A smaller body of research also suggests that diabetes can increase your risk of experiencing leg cramps, potentially due to swings in blood sugar levels, certain medications, and long-term complications such as diabetic neuropathy (nerve damage).1,2 With or without diabetes, these cramps are characterized by the sudden, involuntary, and painful tightening (contraction) of a muscle. They occur most frequently in the evenings in the following muscle groups: Calf muscles (back of the lower leg) Hamstrings (back of the thigh) Quadriceps (front of the thigh) Cramps can also occur in the hands, feet, arms, neck, and abdomen What causes these painful cramps and how can I prevent them? “Although the exact cause of muscle cramps remains unknown, they are not inevitable,” says Amy Hess-Fischl, MS, RD, LDN, BC-ADM, CDE. While cramps may seemingly come on without warning, knowing the factors and situations that can cause muscle cramps can help you understand them, prevent them, and treat them. Here, some reasons for cramps and what you can do to avoid them: Uncontrolled blood sugar levels. Glucose is required for muscles to contract and relax, so if your blood sugar levels are too high or low, it impacts the body’s ability to regulate these activities properly.1 Controlling your blood sugar levels is important Continue reading >>

Prosthetics And Diabetes – Keeping Diabetic Patients On Their Own Two Feet

Prosthetics And Diabetes – Keeping Diabetic Patients On Their Own Two Feet

The occurrence of diabetes, already the leading cause of limb loss in the United States, is growing. Prosthetists, orthotists and pedorthists see more patients with diabetes than any other presenting condition. If any patient type can be described as the foundation of O&P practice in this country, it would be the older diabetic individual with peripheral sensory neuropathy. Despite decades of progress in managing the disease, the course of diabetes still frequently culminates in varying degrees of lower-limb morbidity and ultimately amputation. An estimated 90,000 lower-limb amputations were performed on diabetic patients last year with vascular insufficiency secondary to diabetes as the predominant cause. With other types of practitioners usually involved in diabetic limb care, we frequently do not see a diabetic patient until an infection, lesion or deformity has progressed to the point that amputation has become the best option, and we are engaged to provide prosthetic management. However, be assured our team is well prepared to help at risk patients preserve their intact limbs, be it one limb following amputation of the other… or both. Another disturbing diabetes statistic reveals that up to 50 percent of surviving diabetic amputees will lose their contralateral limb within five years of an initial amputation. Our goal is not to add to that number. In the case of unilateral diabetic amputees, it is not uncommon to have rigorous orthotic-pedorthic management under way for the non-amputated leg while active prosthetic care is in progress. Such is particularly the case during the period of extensive gait training that accompanies the recent amputee’s transition to prosthetic ambulation when considerable additional loading is applied to the remaining foot’s planta Continue reading >>

Diabetes And Foot Problems Treatment And Complications

Diabetes And Foot Problems Treatment And Complications

Diabetes and foot problems facts Two main conditions, peripheral artery disease (PAD) and peripheral neuropathy, are responsible for the increased risk of foot problems in people with diabetes. Symptoms and signs of diabetic foot problems arise due to the decreased sensation from nerve damage as well as the lack of oxygen delivery to the feet caused by vascular disease. Diabetic foot problems also include bunions, corns, calluses, hammertoes, fungal infections, dryness of the skin, and ingrown toenails. These problems are not specific to diabetes, but may occur more commonly due to the nerve and vascular damage caused by diabetes. Treatment depends on the exact type of foot problem. Surgery or even amputation may be required for some cases. Gangrene (dry gangrene) is tissue death due to absence of blood circulation. It can be life threatening if bacterial infection develops (wet gangrene). Many diabetes-related foot problems can be prevented by good control of blood sugar levels combined with appropriate care of the feet. How can diabetes cause foot problems? Both type 1 and type 2 diabetes cause damage to blood vessels and peripheral nerves that can result in problems in the legs and feet. Two main conditions, 1) peripheral artery disease (PAD), and 2) peripheral neuropathy are responsible for the increased risk of foot problems in people with diabetes. Peripheral artery disease (PAD), sometimes referred to as peripheral vascular disease (PVD), means that there is narrowing or occlusion by atherosclerotic plaques of arteries outside of the heart and brain. This is sometimes referred to as "hardening" of the arteries. Diabetes is a known risk factor for developing peripheral artery disease. In addition to pain in the calves during exercise (medically known as intermitte Continue reading >>

This May Be Causing Your Leg Pain And Numbness

This May Be Causing Your Leg Pain And Numbness

Aching calves, burning legs, numbness in the feet — pain and discomfort in the lower extremities is a common complaint that sends many of us to our doctors seeking relief. But unless the cause is something obvious, like a fall, pinpointing the source may require some medical detective work. Trying to tough it out, though, will not get you any closer to the answers. “Leg pain that comes on acutely with a bang, is severe and doesn’t resolve within minutes probably needs to be seen right away,” as it could be a sign of a more serious condition, says Dr. Benjamin Wedro, a clinical professor of medicine at the University of Wisconsin and an emergency physician at Gundersen Medical Center in Lacrosse, Wis. “There’s no trophy for suffering.” Here are some of the potential causes of leg and foot pain: Pain that occurs when walking or exercising may be the result of claudication or decreased blood supply to the legs. This condition is most often a symptom of peripheral arterial disease, or PAD, a narrowing of the arteries that deliver blood to your limbs, typically caused by the buildup of plaque or fatty deposits. Smoking, high cholesterol, high blood pressure and obesity are major risk factors for PAD. “The leg pain from PAD tends to occur when you’re active,” says John Fesperman, a family nurse practitioner at Duke Primary Care in North Carolina. “When you’re active, muscles need more blood. The lack of adequate blood triggers pain, which is known as intermittent claudication. Once you stop moving, the pain usually disappears.” Deep vein thrombosis, or DVT, a blood clot in a deep vein that develops after extended periods of inactivity, can also cause major leg pain. Long flights or car rides make it difficult for the leg to return blood back to the h Continue reading >>

The Reasons Why The Strength In One's Legs Weakens As You Age

The Reasons Why The Strength In One's Legs Weakens As You Age

You know it's bad to sit too much. However, you don't think you have a problem until you need your hands to get out of a chair. Physiological changes in the muscles make loss of leg strength a common problem as people age, and insufficient activity, diabetes and other health problems can make matters worse. Normal Changes Some loss of muscle mass, called atrophy, is normal with aging, and the amount may be determined partly by genetics. The working fibers of the muscles shrink, and fat and fibrous tissue replace some of former muscle volume. This atrophy may begin in males in their 20s and in women in their 40s. Changes in nerve function also reduce the amount of muscle contraction and tone, causing muscles to lose strength. Lack of Exercise Too much chair time may make age-related weakness in your legs worse. If you have outsourced the cleaning and gardening, you probably aren't as active as you used to be. Even 90-year-olds can improve muscle strength through strength training, notes Roy J. Shephard of the University of Toronto Faculty of Medicine. Some helpful methods include bodyweight exercises, such as squats, free weights and weight machines. Ask your physician what leg exercises are best for you. Endocrine Problems Endocrine disorders can cause leg weakness. For example, diabetes often causes nerve damage in the legs and feet, called diabetic neuropathy. The result is pain or numbness and weakness in the legs. Overweight diabetics and those with poor blood sugar control are more likely to have these problems. People with insufficient thyroid hormones also sometimes experience weak muscles in the legs and elsewhere. Spine and Back Problems Various problems with the spine and back can cause weakness in one or both legs. In sciatica, for example, a spinal disk or a Continue reading >>

Why Do Diabetics Lose Their Feet And Legs?

Why Do Diabetics Lose Their Feet And Legs?

First, a disclosure: I am not an MD, just a medicine enthusiast. Tl;Dr : diabetics "lose" their feet because of tissue necrosis, infection and slow/non-recovering wounds, all of which are long term complications of diabetes. Other than that, diabetics stands at a higher risk of loss of feeling in peripheral limbs. Diabetes is an abnormally high level of glucose in the blood. the excess glucose damages all the functions of the circulatory system. The basic oxygen distribution is restricted and limited due to the formation of plaque in the arteries, essentially lowering the blood flow in them. In smaller arteries, the blood flow isn't slowed, it is stopped altogether, starving and eventually killing the cells down the line, making the tissue necrotic. Once a part of a limb turns necrotic, there is no other option but to remove it. Another function of the circulatory system that is severely weakened by diabetes is the delivery of immune system, more specifically, the ability of white blood cells to reach a wound in peripheral areas clogged up by plaque. This results in a more serious infection of the hurt limb. These infections are often aggravated because of the low oxygen supply to the infected area, since enough oxygen is paramount for quick wound recovery. Some diabetics show another symptom that puts them at an even higher risk of losing their feet. Advanced diabetes can cause numbness and even complete loss of sensation in toes and feet. Such inflicted person can accidentally hurt his feet, say step on a nail, and not be aware of that. Such person will discover and clean his wound later than he would wish, and experience unnecessary blood loss and increased chance of infection. His wound will also heal a hell of a lot slower than that of a healthy person. Losing a li Continue reading >>

Type 2 Diabetes And Amputation

Type 2 Diabetes And Amputation

Nerve disease caused by type 2 diabetes is the leading cause of amputation of feet, toes, legs, hands and arms among diabetes sufferers. Collectively, the disorders which cause these amputations are called Diabetic Neuropathies. Foot problems are the most frequent reasons for hospitalization of people with type 2 diabetes. But many diabetes-linked hospitalizations and amputations could be prevented by better management of diabetes via increased insulin sensitivity and the reversal of the imbalance of blood glucose and insulin called Insulin Resistance. The earlier that action is taken to maximize insulin sensitivity, the greater the chance is of avoiding the need for amputation. Sadly, jazz legend Ella Fitzgerald received a late diagnosis of diabetes and had to have both legs amputated below the knee. People with diabetes can, over time, develop damage to nerves throughout the body. Neuropathies lead to numbness and sometimes pain and weakness in the hands, arms, feet, and legs. Problems may also occur in other areas, including the digestive tract, heart, and sex organs. Persons with diabetes can develop nerve problems at any time. But the longer a person has diabetes, the greater the risk. An estimated 50% of persons with diabetes have some form of neuropathy, though not all those with neuropathy have symptoms. The highest rates of neuropathy are among people who have had the disease for at least 25 years. Diabetic neuropathy also appears to be more common in people who have problems controlling their blood sugar, in people with high levels of blood fat and blood pressure, in overweight people and in those over the age of 40. The most common type of neuropathy is peripheral neuropathy - also called distal symmetric neuropathy - which affects the arms and legs. Research Continue reading >>

Diabetic Foot Care - Symptoms

Diabetic Foot Care - Symptoms

A A A Diabetic Foot Care (cont.) Write down the patient's symptoms and be prepared to talk about them on the phone with a doctor. Following is a list of common reasons to call a doctor if a person with diabetes has a diabetic foot or leg problem. For most of these problems, a doctor visit within about 72 hours is appropriate. Any significant trauma to the feet or legs, no matter how minor, needs medical attention. Even minor injuries can result in serious infections. Persistent mild-to-moderate pain in the feet or legs is a signal that something is wrong. Constant pain is never normal. Any new blister, wound, or ulcer less than 1 inch across can become a more serious problem. The patient will need to develop a plan with a doctor on how to treat these wounds. Any new areas of warmth, redness, or swelling on the feet or legs are frequently early signs of infection or inflammation. Addressing them early may prevent more serious problems. Pain, redness, or swelling around a toenail could mean the patient has an ingrown toenail - a leading cause of diabetic foot infections and amputations. Prompt and early treatment is essential. New or constant numbness in the feet or legs can be a sign of diabetic nerve damage (neuropathy) or of impaired circulation in the legs. Both conditions put the patient at risk for serious problems such as infections and amputations. Difficulty walking can result from diabetic arthritis (Charcot's joints), often a sign of abnormal strain or pressure on the foot or of poorly fitting shoes, as well as the inability to perceive pain. Early intervention is key to preventing more serious problems including falls as well as lower extremity skin breakdown and infections. Constant itching in the feet can be a sign of fungal infection or dry skin, both of wh Continue reading >>

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