Tuesday, August 18, 2009

Exercise Encouraged With A Good Diet

Exercise has long been considered an important method to improve and prevent diabetes. It has been shown in multiple studies to improve blood sugars and it improves insulin sensitivity. The method of this improvement includes exercise inducing proliferation of glucose-transport molecules that then move to the cell membrane. In a recent study, however, vitamin supplements with vitamin C and vitamin E blunted this effect. It was found that with these supplements insulin sensitivity was not improved with exercise. Better than supplements, therefore, would be the diet rich in fruits and vegetables to continue to improve insulin sensitivity with exercise.

For more information: Ristow M et al. Antioxidants prevent health-promoting effects of physical exercise in humans. Proc Natl Acad Sci U S A 2009 May 26; 106:8665. [Free full-text online] [Medline® Abstract]

Dr Gibson also has an additional blog on Diabetes.

Tuesday, August 4, 2009

Save a Leg, Save a Life

One of the many complications associated with diabetes is the presence of diabetic foot ulcers. These ulcers are open wounds that are slow to heal, and affect roughly fifteen percent of all diabetic patients. Often the wound is explained by a loss of sensation in the foot, and the patient can not feel that there is an open sore on the bottom of their foot, and may not see it, either.

When the ulcers become infected, which is usually the case; the infection can quickly spread to the other tissues. This can lead to infections of the bone (osteomyelitis) or of the blood (sepsis). Complications due to diabetic foot ulcers will often lead to amputations or even death.

On average, a lower extremity amputation will cost close to $50,000 annually. This cost is mostly from hospital stays and aftercare related to the surgery. Of the patients that do have an amputation, less than 50% will be able to walk with a prosthesis following a below the knee amputation, and less than 25% will be able to walk with a prosthesis following an above the knee amputation. Without the ability to move around on their own, many patients become institutionalized, which can cost upwards of $100,000 per patient. With a 25% reduction in the amount of lower extremity amputations each year, over $4 billion would be saved annually.

Save a Leg, Save a Life is an organization that is devoted to educating doctors and the public on the ways to address these issues. The organization is an interprofessional team, made up of podiatrists, vascular surgeons, nurses, and many other types of doctors with an interest in wound care. The organization seeks to provide information about the advanced methods of treating wounds, including new materials and technologies used in the treatment of diabetic foot ulcers.

Health care providers and health insurance companies are becoming more and more dependent on evidence based medicine as a foundation for treatment. Through Save a Leg, Save a Life, that information is being dispersed through the medical community. Products that are designed to help regenerate healthy tissue and promote healing are replacing the old methods of washing the wound with saline solution. However, these old methods are all that many doctors know, and so they become the standard in wound care. Through programs like Save a Leg, Save a Life, as well as the American Academy of Wound Management and the College of Certified Wound Specialists, hopefully the more advanced methods will become the new standard.