March 2011

CDC Estimates More Than 8 Percent In U.S. Have Diabetes

By Brian McCurdy, Senior Editor

The number of Americans with diabetes continues to escalate. Approximately 25.8 million people have diabetes, about 8.3 percent of the United States population, according to new estimates from the Centers for Disease Control and Prevention (CDC). This is an increase of 2.2 million people since the last CDC estimates released in 2007. The new total includes 7 million people who are unaware that they have the disease.

   In addition, the CDC notes that 79 million people 20 years of age or older — or 35 percent of those 20 years of age or older — have pre-diabetes in comparison to 57 million people 20 years of age or older in 2007.

   Both Stephanie Wu, DPM, and Ronald Sage, DPM, attribute the rising prevalence of diabetes and pre-diabetes to a sedentary lifestyle and unhealthy eating habits, which lead to obesity, the number one risk factor for type 2 diabetes. Dr. Wu cites statistics from the National Center for Health Statistics showing that nearly 30 percent of adults in the United States are obese. Dr. Sage adds that a diet high in calories and carbohydrates sets people up for metabolic syndrome. He notes that metabolic syndrome is characterized by obesity and glucose intolerance, and leads to pre-diabetes.

   Dr. Sage notes preventive methods for patients with pre-diabetes include a general physical examination to identify risk factors such as hyperglycemia, elevated blood pressure, lipid abnormalities and elevated body mass index. Treatment may include exercise, lifestyle modifications and medication, says Dr. Sage, a Professor and the Chief of the Section of Podiatry at the Department of Orthopaedic Surgery and Rehabilitation at the Loyola University Stritch School of Medicine in Maywood, Ill.

    “Losing a modest amount of weight (5 to 10 percent of total body weight) through diet and moderate exercise (walking 30 minutes a day, five days a week) can make a big difference,” says Dr. Wu, an Associate Professor of Surgery at the Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science in Chicago. Since people with pre-diabetes have a 50 percent increase in risk for heart disease or stroke, she emphasizes treatment for hypertension and high cholesterol.

   In addition to obesity, Dr. Wu cites other risk factors for diabetes like increased age, a family history of the disease, ethnicity, hypertension, hypercholesterolemia and gestational diabetes. Modifiable risk factors for diabetes include smoking and high alcohol consumption, according to Dr. Wu.

Emphasizing Increased Awareness Of The Disease

To prevent the spread of diabetes, Dr. Wu acknowledges the importance of educating patients on diabetes and its devastating complications. She notes that many patients have no idea they even have diabetes until they go to the emergency room with a diabetic foot infection. She and Dr. Sage advocate having ad campaigns as well as news and magazine articles that address diabetes prevention. Dr. Sage also suggests supporting organizations like the American Diabetes Association (ADA) in informing the population about the seriousness of diabetes.

   Dr. Wu also suggests incorporating diabetes awareness into the education of young children and their parents.

    “Childhood obesity is becoming problematic in the U.S. and educating the young and their parents to make healthy food choices and be more active will help. Basically, increasing awareness of the disease overall will help prevent spread of the disease,” says Dr. Wu.

Do Socioeconomic Factors Influence The Quality Of CLI Care?

By Brian McCurdy, Senior Editor

A recent study in the Journal of Vascular Surgery suggests that the poor and minorities may be more likely to undergo amputation for critical limb ischemia (CLI).

Comments

There is an abundance of material in the podiatric literature largely directed to podiatrists by podiatrists and for podiatrists. The trends in general mainstream medicine integrating some commonly used modalities seems somewhat lost on podiatrists. The use of sildenafil, an ED drug and a PDE-5 inhibitor, has remarkable effects for peripheral neuropathy and Raynaud's.

Why isn't this in the podiatry literature? It is remarkable how the cabal of podiatry remains in its shell while mainstream medicine integrates knowledge. Perhaps the limitations of license preclude podiatrists from exploring modern medical procedures or perhaps a general self imposed ignorance. It appears the stubborn nature of podiatry and its place in medicine, misunderstood as it is, will ultimately disappear,

Will podiatry survive a cure for diabetes?

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