November has been declared National Diabetes Month by the American Diabetes Association, which makes this a great time to talk about facts, care and prevention of complications, and how it relates to the patients in my NYC podiatry practice. Without a doubt, diabetes is an epidemic that is getting worse – fast. There are currently 26 million people in the US with diabetes, 4100 new cases are diagnosed every day, and it is estimated that by 2050, 1 in 3 million people may have the disease. And it’s not just here – for instance, there are more diabetics in India than there are people in America.
As a basic review, there are two known types of diabetes – aptly named type 1 and type 2. Type 1 typically affects juveniles, and in this process the pancreas stops producing insulin, thereby inhibiting the body’s ability to process glucose. Type 2 is the more common presentation of diabetes in adult patients, and involves the body becoming less sensitive to insulin. Treatment is aimed at providing external forms of insulin in type 1, and initially medications that process or decrease glucose in type 2.
Complications ensue when the sugar levels are left unchecked. Over time glucose causes thickening of the arteries that lead to the feet, kidneys, eyes, heart and brain. It is for this reason that diabetes is the leading cause of kidney failure – 120 new cases every day, and blindness – 55 cases every day.
Just as important are the effects on the nerves, especially those that provide sensation to the feet. Over time elevated glucose levels can lead to a metabolic breakdown of the nerves, resulting in a condition called diabetic neuropathy, or nerve death. The numbness that ensues can be so profound that patients don’t feel a small cut or blister until it becomes a major infection requiring amputation of a toe, foot or leg. And it is for this reason that 70% of the non-traumatic amputations worldwide are performed on diabetics, and why a diabetic foot infection is the leading reason that diabetic patients are hospitalized and why there are 230 amputations performed every day in the US. This is why diabetic foot care is so critical.
So what can you do?
Follow the ABC’s of diabetes:
- Know your A1C- the number that represents the three month diabetic control
- Control your blood pressure – ideally under 120/80
- Maintain your cholesterol – LDL under 100, preferably under 70.
- Eat right.
- Exercise regularly. No time? How about 15-20 minutes of walking 5 days per week.
- And of course, visit your NYC podiatrist. Study after study has demonstrated the life and limb saving benefits of regular visits to a podiatrist.
Let’s work together to reduce the scourge of diabetes. We may not be able to cure it, but we can treat it!
See you in the office.
Dr. Ernest L. Isaacson