By Gordon Zernich, CP, BOCPO, Tomas Dowell, CPO, LPO, and Ronald B. Tolchin, DO, FAAPM&R
Sensory neuropathy is the most common form of diabetic neuropathy. Nerve damage results from poorly managed and chronically high levels of blood sugar. In patients who have type 1 diabetes, which usually affects those 25 years and younger, there is insulin deficiency. In regard to people with type 2 diabetes, their insulin production inadequately meets the body’s daily need to metabolize... Read More.
Lauren A. Fisher, DPM, Hillarie L. Sizemore, DPM, and Khurram H. Khan, DPM
Peripheral arterial disease (PAD) is a very common condition that affects 20 to 30 percent of patients over 50 years of age, equating to an estimated 10 million Americans. As the population ages, the incidence of PAD will likely increase dramatically.1
Intermittent claudication is a symptom among patients with PAD and one can use the presence of these symptoms as a diagnostic tool.2 True... Read More.
In the early 1980s, LoGerfo opened the window of limb salvage in critical stages of diabetic atherosclerosis by fighting the misconception of microangiopathy that had previously prevented attempts to bypass arterial lesions in diabetic foot.1 He produced evidence that revascularization of distal diabetic arterial occlusions can be successful. This evidence in turn gave a fundamental push to... Read More.
Diabetic peripheral neuropathy is very common sequelae of diabetes mellitus. Patients often complain of burning, tingling, numbness and even sharp stabbing pain. These symptoms can cause sleep disturbances as well as problems with daily activities. Many primary care physicians and podiatrists overlook these symptoms which, in most cases, have been going on for years.
Many people are unaware of... Read More.
Recent advancements in technology have led to numerous adjunctive therapies for healing chronic wounds. In many cases, though, we can achieve healing in a short period of time once we identify the underlying factors that inhibit proper healing. With this in mind, let’s take a closer look at some of these common impediments.
While wound hypoxia is the most common obstacle we see, it is also the... Read More.
By Richard M. Stillman, MD, FACS
Clinical Editor: John Steinberg, DPM
Managing foot wounds in diabetes patients forms much of the core practice of wound care and podiatry. In the United States, the annual cost for the care of diabetic foot wounds exceeds $5 billion.1 It’s been estimated that anywhere from 2.5 to 10.7 percent of patients with diabetes develop a foot wound each year. Even for wounds that heal, the recurrence rate is approximately 55 percent over the... Read More.
It is believed that 15 percent of diabetics will develop a foot or leg ulceration at some point during the course of their disease and that 50 percent will recur within 18 months.1 Approximately 80 percent of diabetic ulcers occur plantarly due to abnormal pressures. Most of these ulcers can be treated with sharp debridement, offloading devices and local wound care.2-4 Once you’ve achieved ulcer... Read More.
Every year, 800,000 additional cases of diabetes are diagnosed and it is projected that nearly 9 percent of all Americans will have diabetes by the year 2025.1 More shockingly, the incidence of diabetes has gradually increased among young people over the last decade, mainly related to an increase in obesity and sedentary lifestyles. In addition, diabetes may commonly reappear in women who... Read More.
When it comes to peripheral vascular disease, you can use many modalities to detect and evaluate this disease. Arteriography is the gold standard and provides excellent anatomic detail, but it is invasive and requires ionizing radiation and administration of contrast. It also provides very limited physiologic or functional information.
Indeed, it’s important to be aware of the role of noninvasive... Read More.
A recently released study by The Centers for Disease Control and Prevention (CDC) revealed that the number of diagnosed cases of diabetes rose by a third (from 4.9 to 6.5 percent) between 1990-1998. This percentage will increase to 9 by 2025. The breakdown of cases by age was particularly alarming. The incidence of diabetes increased 40 percent over a period of eight years for people 40 and over... Read More.
The research of the ‘70s and ‘80s seems to have paid off in the array of high-tech bioactive wound care products and innovative dressings that have emerged on the market in recent years. We have seen new and improved hydrogels, alginates, growth factors, living skin equivalents and vacuum assisted closure, not to mention new classes of antibiotics to cover emergent drug resistant organisms and... Read More.
By Jennifer Jansma, DPM, and John S. Steinberg, DPM
It has been estimated that neuropathy affects between 10 to 50 percent of patients with diabetes. Specifically, autonomic sensory neuropathy is associated with a number of clinical entities such as postural hypotension, cardiac arrhythmia, bladder dysfunction and gastrointestinal motility disturbance. Symptoms of gastrointestinal motility abnormalities can include nausea, vomiting, post-prandial... Read More.