Tag: neuropathy

Footnotes: Nutritional Considerations For Diabetic Foot Ulcers

Hi, there. My name is Nicole Curreri, and I’m currently a fourth‑year podiatry student at Temple University School of Podiatric Medicine. My co‑authors, Ms. Diana Johnson, who’s a nutritionist and dietician, along with Dr. Khurram Kahn, a DPM at Temple (University School of Podiatric Medicine), have worked together on an article that emphasizes the role of nutrition in healing and treating diabetic foot ulceration.

Podiatrists treat lower extremity wounds secondary to pressure, diabetes, neuropathy, trauma, etc. Most commonly, we treat diabetic foot ulcerations. About 10 to 15 percent of patients with diabetes will go on to develop a diabetic foot ulceration … read more

Keys To Addressing Forefoot Plantar Ulcerations

The Centers for Disease Control and Prevention (CDC) estimates one in ten Americans have diabetes and one in three have prediabetes … Diabetes is also increasing among younger populations and can lead to sleep apnea, cardiovascular disease, pulmonary disease and risk of cancer … One major complication of diabetes is diabetic peripheral neuropathy (DPN), seen in 50 percent of the geriatric population with diabetes … continue

Predictors of lower extremity amputation among

     patients with diabetic foot ulcer in a tertiary health facility in north central Nigeria


INTRODUCTION: Diabetic foot ulcer is a complication of diabetes mellitus of great public health importance. It has the potential of leading to the dreaded sequelae of lower extremity amputation. This outcome is associated with significant morbidity and mortality, hence the need to explore its predictors among persons with diabetic foot ulcers.

METHODOLOGY: The study involved the review of the medical records of seventy (70) in-patients who had received treatment for diabetic foot ulcer at the Federal Medical Centre, Keffi, North Central Nigeria. In addition to obtaining sociodemographic and medical history, information on the Wagner grade of the ulcer, the presence of peripheral sensory neuropathy (using the 10g monofilament) and the presence of osteomyelitis (using plain X-ray of the foot) were obtained and documented. The prevalence rate of lower extremity amputation was also determined.

RESULTS: The study population comprised 52.9% males and 42.1% females. The mean age for male and female participants were 53.4±10.5 and 58.8±13.0 years respectively ( t = 2.35; p = 0.061). Majority of study subjects (37.1%) had Wagner grade 2 disease. Prevalence rate of amputation was 38.6%. Among the potential predictors of lower extremity amputation analyzed (Age, sex, foot care education, duration of diabetes, cigarette smoking, walking bare feet, impaired vision, peripheral neuropathy, hypertension, previous foot ulcer, osteomyelitis), none of them demonstrated a significant association with lower extremity amputation.

CONCLUSION: The list of potential predictors of lower extremity amputation considered in this study is by no means exhaustive. More studies involving larger study populations and other potential predictors of lower extremity amputation not considered in this work (such as peripheral artery disease and glycated haemoglobin) are encouraged.

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Retired surgeon leads local diabetes study

SHERIDAN — After working as an orthopedic surgeon for 20 years, Dr. Scott Nickerson was forced into an early retirement by diabetes.


After graduating from the Johns Hopkins University School of Medicine, Nickerson moved to Sheridan in 1977 to work as an orthopedic surgeon at Sheridan Orthopaedics, which was a small three-doctor practice at the time.


One of the many complications of diabetes is neuropathy, nerve damage that can lead to pain, weakness and loss of sensation in the extremities.


Nickerson said after living with diabetes for about 10 years, he began to notice his hands were getting clumsy.


“I would drop tools a little bit or just not have quite the sensation you would depend on to do the work,” Nickerson said. “Plus it would hurt me a lot to be on my feet.”


Nickerson decided to retire so the effects of his neuropathy would not affect his work as a surgeon … read more

Lower Extremity Amputation and Reamputation Predictors ….

Review: Lower Extremity Amputation and Reamputation Predictors in Patients with Diabetic Foot Wounds


A major concern in managing patients with diabetes is their susceptibility to acquiring ulcers in their feet. If these patients are not careful, these ulcers may become infected and eventually lead to additional sequelae, ending in lower extremity amputation. The focus of this study was to determine the major factors of lower extremity amputation in the diabetic foot, in hopes that clinicians may be able to reduce the rate of amputations more effectively.


The authors performed a retrospective review of the records of 132 consecutive patients who had already received a lower extremity amputation or reamputation as a result of diabetic wounds. All patients had been diagnosed with diabetes mellitus type 2, and demographic and clinical data were collected on all of them. These data included age, sex, cigarette smoking history, duration of diabetes, diabetic comorbidities (nephropathy, neuropathy), general comorbidities (peripheral artery disease, hypertension, hyperlipidemia, malignancy), leukocytosis, wound infection status, and culture microorganism and antibiogram results. The side and level of amputation or reamputation were also recorded. Only those patients with wounds of a Wagner-Meggitt classification of 3 to 6 were included … read more

Reexamining The Gold Standard For Offloading Of DFUs

Although the total contact cast can be effective for offloading diabetic foot ulcers, it is not in wide usage. These authors assert the gold standard for offloading lies in the non-removability of the device and offer a closer look at the merits of transitional offloading.


According to the American Diabetes Association, there are approximately 29.1 million Americans, or 9.3 percent of the population, who suffer from diabetes.1 Twenty-one million of these people have already been diagnosed with the disease and 8.1 million remain undiagnosed.


This number, although large, pales in comparison with the 86 million Americans who have been classified as “pre-diabetic” and who are at risk of having diabetes in the near future.1 Each year, 1.7 million Americans 20 years of age or older add to this number. This amounts to 4,660 people per day or one new patient with diabetes every 19 seconds. A full 25.9 percent of Americans age 65 or older suffer from diabetes and its complications. Almost twice as many American Indians (15.9 percent) and African-Americans (13.2 percent) develop the disease as Caucasians (7.6 percent) with Hispanics close behind (12.8 percent). Asian-Americans are not spared as 9 percent of this population will develop the disease and its many complications.


Glycosylation affects all organ systems and leads to complications such as dyslipidemia with an increased incidence of hypertension, and systemic vascular disease. It also leads to the development of a progressive ascending peripheral neuropathy with a loss of sensation and sweat gland function. This in turn leads to ulceration and, in some cases, amputation when infection of the wounds goes unchecked by an immune system that is also compromised by the process …
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