Credit: www.footankleinstitute.com |
Need for improved detection and
management of those with diabetes and foot ulcers.
People
with diabetes who develop foot ulcers are at more risk of dying prematurely
than those without the complication, finds a new large-scale study.
Diabetes can damage a person's blood
vessels and nerves,
especially if their blood sugar is poorly controlled. Poor circulation and
nerve damage in the feet makes people vulnerable to unnoticed cuts or other
injuries and progress into poorly healing ulcers, or sores. In severe cases,
this can lead to foot or leg amputation.
In
a study of 17,830 patients with diabetes -- 3,095 diagnosed with foot
ulceration and 14,735 without -- researchers from St George's, University of
London investigated how diabetic foot ulcers affected a person's risk of dying
earlier. They found that those with a history of foot ulceration had a higher
death rate than those without. There were an extra 58 deaths per 1,000 people
each year with diabetic foot ulcers.
People with foot ulcers and diabetes
showed more cardiovascular risk factors, such as high blood pressure, and were
more likely to die from cardiovascular causes. Approximately half of the
additional mortalities were due to cardiovascular disease, such as heart attack
or stroke.
The
cause of non-cardiovascular deaths was not studied as part of this
investigation but the researchers say this is potentially linked to infections
and complications of foot ulceration, such as blood poisoning.
Robert
Hinchliffe from St George's, University of London, who co-led the study, said:
"Our research, which is the largest and therefore most reliable study to
date, shows that people with diabetes who have foot ulcers are at considerably
higher risk of an earlier death compared to those patients without. We suspect
that this may be due in part to the effect of infections among those with foot
ulcers and the greater co-existence of cardiovascular disease and foot ulcers
with diabetes although the reasons are not entirely clear."
The
researchers say these results underline the importance of a two-pronged
approach for people with diabetes:
-
Enhanced
foot ulceration screening as early detection and treatment may help reduce some
of the complications; and
-
More
intensive control of blood pressure and cholesterol among those diagnosed with
foot ulcers as they are at higher cardiovascular risk.
Currently,
experts already recommend that people with diabetes undertake a number of
precautions to prevent foot ulcers including blood sugar control, wearing socks
to prevent cuts, self-checking for abrasions and getting a complete foot
examination at least once a year.
Existing
guidelines to prevent cardiovascular disease include healthy diet choices,
regular exercise, a medical check-up at least once a year and, often, medically
prescribed drug treatment.
###
The
above story is based on the October 10, 2012 news release by the University of
St George's London.
The
finding has been published in Diabetologia, the journal of the European
Association for the Study of Diabetes:
J.
R. W. Brownrigg, J. Davey, P. J. Holt, W. A. Davis, M. M. Thompson, K. K. Ray,
R. J. Hinchliffe. The association of
ulceration of the foot with cardiovascular and all-cause mortality in patients
with diabetes: a meta-analysis. Diabetologia,
2012; 55 (11): 2906 DOI: 10.1007/s00125-012-2673-3
Caring for Your Feet
There
are many things you can do to keep your feet healthy.
Take care of your diabetes. Work with your
health care team to keep your blood glucose in your target range.
Check your feet every day. Look at your
bare feet for red spots, cuts, swelling, and blisters. If you cannot see the
bottoms of your feet, use a mirror or ask someone for help.
Be more active. Plan your
physical activity program with your health team.
Ask
your doctor about special shoes.
Wash your feet every day. Dry them
carefully, especially between the toes.
Keep your skin soft and smooth. Rub a thin coat
of skin lotion over the tops and bottoms of your feet, but not between your
toes. Read more about skin care.
If you can see and reach your toenails, trim them when
needed. Trim your toenails straight across and file the edges with an emery
board or nail file.
Wear shoes and socks at all times. Never walk
barefoot. Wear comfortable shoes that fit well and protect your feet. Check
inside your shoes before wearing them. Make sure the lining is smooth and there
are no objects inside.
Protect your feet from hot and cold. Wear shoes at
the beach or on hot pavement. Don't put your feet into hot water. Test water
before putting your feet in it just as you would before bathing a baby. Never
use hot water bottles, heating pads, or electric blankets. You can burn your
feet without realizing it.
Keep the blood flowing to your feet. Put your feet
up when sitting. Wiggle your toes and move your ankles up and down for 5
minutes, two (2) or three (3) times a day. Don't cross your legs for long
periods of time. Don't smoke.
Get started now. Begin taking
good care of your feet today. Set a time
every day to check your feet.
Get
more details from the American Diabetes Association HERE.
Next:
Next:
Exercise Helps Ease Premature
Cardiovascular Aging Caused by Type 2 Diabetes
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