Diabetes and its foot complications: Tests and treatments


Foot amputation, together with kidney disease and eye damage, has decreased significantly over the final a number of years. Lowerextremity amputations per 1,000 individuals with diabetes peaked in 1996 and declined by half in 2003. "By taking proper care of your feet, wearing suitable footwear, and getting regular foot exams, you can quit foot trouble before it starts," says Birgitta Rice, diabetes educator and foot specialist. Specialists agree that with simple, preventive foot care practices and great blood glucose control, you can greatly decrease your risk of foot problems and amputation.

Rice knows of what she speaks, having lived with type 1 diabetes for forty-nine years without foot complications. My personal podiatrist, Dr. Joseph Stuto, has told me over the final a number of years, "You're doing everything you can to avoid a foot problem; you walk, you're lean, and you maintain control of your blood sugar. Do not be concerned, just maintain it up." Like Rice, I've had type 1 diabetes a lengthy time - thirty-seven years - and I have no foot problems.

Your podiatrist can perform certain tests to check the well being of your feet. The last time I was in Dr. Stuto's office, he was conducting ankle-brachial index (ABI) testing on his patients. ABI tests check ankle pressure against arm pressure to determine whether there is any narrowing or blockage of the arteries that supply blood towards the legs and feet (a condition called peripheral arterial illness).

It's a simple, painless test that indicates whether you are at risk for circulatory foot problems. Such preventive tests can often ward off an amputation. Rice told me a remarkable story of a man who was scheduled to have his toes amputated as a consequence of a severe rash (ischemic petechia) and impending gangrene. A few days before the surgery, excruciating pain in his feet brought this man to his main care physician.

His physician taught the man the relaxation and biofeedback technique called WarmFeet to relieve the man's pain: By measuring the temperature of the skin surface of his feet and focusing his mind to send healing warmth there, the patient measurably improved blood flow and circulation to his feet. This not only relieved the man's pain but also improved the skin and tissues of his foot so significantly that the amputation was canceled.

Hyperbaric oxygen therapy (HBOT) has also been used to heal gangrene and stop amputation. HBOT requires soaking your feet in extremely oxygenated water for an hour or an hour along with a half once or twice each day, for a number of weeks. This transports extra oxygen to oxygenstarved tissue, often causing the gangrene to disappear. Many scientists and physicians think HBOT can provide dramatic improvements in wound healing, diabetic neuropathy, ulcers, burns, along with other conditions in which poor circulation plays a role.

If a foot problem has gone too far, occasionally an amputation is the only method to restore function and health to the area; at that point an amputation could be a life-saving process. I've interviewed a number of individuals who, not surprisingly, live functional and happy lives with prosthetics. One lady in particular, Kathleen, who's had diabetes for fifty-four years and has lost both her legs to amputation over the last few years, is one of probably the most positive individuals I've ever met.

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