An estimated 80% of lower limb amputations in people with diabetes are preventable, a charity has revealed.
In Northern Ireland, there were 199 diabetes-related amputations last year.
A campaign has been launched aimed at putting a stop to preventable amputations.
'Putting Feet First' by Diabetes UK Northern Ireland wants to reduce diabetes-related amputations by 50% within five years.
Diabetes is a serious condition where the amount of glucose in your blood is too high.
People with Type 1 diabetes do not produce any insulin which is needed in order to control the levels of glucose in the blood. Those with Type 2 diabetes produce an insufficient amount of insulin - or can be insulin resistant.
If blood glucose levels are not maintained at normal levels, it can lead to long-term complications such as heart disease, stroke and amputation.
There are currently 73,500 people diagnosed with diabetes in the region.
Iain Foster, the charity's National Director, said: "A single preventable amputation is one too many so the fact that hundreds of people in Northern Ireland have endured unnecessary foot amputations is nothing short of shameful."
Amputations have a devastating effect on quality of life and so every amputation that results from poor healthcare is a tragedy.
Iain Foster
He explained that diabetic foot problems arise from reduced circulation and damaged nerve endings.
He said a big part of bringing this to an end is giving people with diabetes information about how to look after their feet.
The charity wants everyone with diabetes to get a thorough annual foot check and for a specialist diabetes foot care teams for foot ulcers to deal with referrals within 24 hours.
"Many people with diabetes aren't even aware that amputation is a potential complication. We also need to make sure that people with diabetes understand what healthcare they should be getting."
Mr Foster said there are opportunities within the current healthcare system for problems to be detected early - and treatment obtained - before complications set in.
The campaign will include working with healthcare professionals in GP practices and areas, such as A&E departments, to increase awareness of the signs of early complications and the need for a quick referral to specialist staff.
He added: "Quality of care makes a big difference to amputation rates. Foot ulcers can deteriorate in a matter of hours so failing to refer someone quickly enough can literally be the difference between losing a foot and keeping it."
"It is a scandal that needs to be brought to an end."
Showing posts with label death and diabetes. Show all posts
Showing posts with label death and diabetes. Show all posts
Thursday, June 28, 2012
Tuesday, April 19, 2011
How to Reduce After Breakfast Blood Sugars 40%
A high-protein, low-carbohydrate snack before breakfast attenuates post-breakfast hyperglycemia....
Previous studies have shown a considerable reduction in hyperglycemia after the second meal of the day, provided that breakfast had been taken. The preservation of this effect in Type 2 diabetes was not confirmed until recently. Postprandial hyperglycemia acts as an independent risk factor for cardiovascular disease, a major cause of death in subjects with Type 2 diabetes. It was hypothesized that post-breakfast hyperglycemia in subjects with Type 2 diabetes could be improved non-pharmacologically by using a high-protein, low-carbohydrate prebreakfast snack.
Researchers studied 10 men and women with diet- and/or metformin-controlled Type 2 diabetes. Metabolic changes after breakfast were compared between 2 days: breakfast taken only and soya-yogurt snack taken prior to breakfast.
The results showed that there was a significant lower rise in plasma glucose on the snack day. The incremental area under the glucose curve was 450 ± 55 mmol · min/l on the snack day compared with 699 ± 99 mmol · min/l on the control day (P = 0.013). The concentration of plasma free fatty acids immediately before breakfast correlated with the increment in plasma glucose (r = 0.50, P = 0.013).
This study demonstrated for the first time that the provision of a practical, high-protein, low-carbohydrate snack prior to breakfast reduced by 40% the postprandial plasma glucose increment in people with Type 2 diabetes. These findings confirm a potent expression of the second-meal effect in people with Type 2 diabetes. The importance of the present observation is that a more practical means of improving glucose tolerance could potentially be of therapeutic benefit in people with Type 2 diabetes.
Researchers observed no effect of the prior snack on insulin secretion after breakfast. The mechanism underlying the second-meal effect has been shown to be due to suppression of plasma FFA, allowing greater storage of glucose as muscle glycogen. They had previously demonstrated a strong negative correlation between the decrease of preprandial plasma FFA levels and the postmeal glucose increment. In the present study, a significant positive correlation was found between prebreakfast plasma FFA and the rise in postprandial plasma glucose concentration.
The snack used in the present study was empirically designed. It will be important to optimize both the composition of the snack and the interval before breakfast to maximize the benefit of this approach. In everyday life, the gap between snack and breakfast would have to be accommodated, for instance, by delaying breakfast until mid-morning. Although the snack induced a small increase in plasma glucose, it was minimal and unlikely to contribute to the hyperglycemic burden. The sample size was dictated by prior power calculation (80% power with 10 subjects).
The study demonstrated that a high-protein, low-carbohydrate snack before breakfast attenuates postbreakfast hyperglycemia and further studies must determine whether long-term use is associated with improvement in A1c.
Previous studies have shown a considerable reduction in hyperglycemia after the second meal of the day, provided that breakfast had been taken. The preservation of this effect in Type 2 diabetes was not confirmed until recently. Postprandial hyperglycemia acts as an independent risk factor for cardiovascular disease, a major cause of death in subjects with Type 2 diabetes. It was hypothesized that post-breakfast hyperglycemia in subjects with Type 2 diabetes could be improved non-pharmacologically by using a high-protein, low-carbohydrate prebreakfast snack.
Researchers studied 10 men and women with diet- and/or metformin-controlled Type 2 diabetes. Metabolic changes after breakfast were compared between 2 days: breakfast taken only and soya-yogurt snack taken prior to breakfast.
The results showed that there was a significant lower rise in plasma glucose on the snack day. The incremental area under the glucose curve was 450 ± 55 mmol · min/l on the snack day compared with 699 ± 99 mmol · min/l on the control day (P = 0.013). The concentration of plasma free fatty acids immediately before breakfast correlated with the increment in plasma glucose (r = 0.50, P = 0.013).
This study demonstrated for the first time that the provision of a practical, high-protein, low-carbohydrate snack prior to breakfast reduced by 40% the postprandial plasma glucose increment in people with Type 2 diabetes. These findings confirm a potent expression of the second-meal effect in people with Type 2 diabetes. The importance of the present observation is that a more practical means of improving glucose tolerance could potentially be of therapeutic benefit in people with Type 2 diabetes.
Researchers observed no effect of the prior snack on insulin secretion after breakfast. The mechanism underlying the second-meal effect has been shown to be due to suppression of plasma FFA, allowing greater storage of glucose as muscle glycogen. They had previously demonstrated a strong negative correlation between the decrease of preprandial plasma FFA levels and the postmeal glucose increment. In the present study, a significant positive correlation was found between prebreakfast plasma FFA and the rise in postprandial plasma glucose concentration.
The snack used in the present study was empirically designed. It will be important to optimize both the composition of the snack and the interval before breakfast to maximize the benefit of this approach. In everyday life, the gap between snack and breakfast would have to be accommodated, for instance, by delaying breakfast until mid-morning. Although the snack induced a small increase in plasma glucose, it was minimal and unlikely to contribute to the hyperglycemic burden. The sample size was dictated by prior power calculation (80% power with 10 subjects).
The study demonstrated that a high-protein, low-carbohydrate snack before breakfast attenuates postbreakfast hyperglycemia and further studies must determine whether long-term use is associated with improvement in A1c.
Friday, January 21, 2011
Can Diabetes Be Cured?
Q: I'm 47 years old and was recently diagnosed with diabetes. I'm about 25 pounds overweight and lead a sedentary lifestyle, but I'm starting a diet and an exercise program. Will my diabetes go away if I lose weight, watch my diet, and exercise regularly?
— Mary, Wichita
A:It is wonderful that you are changing your lifestyle to become healthier! This will benefit you greatly, not only in controlling your blood sugar but also in improving your cholesterol levels, strengthening your bones, and improving your heart function. These changes come with a long list of health benefits, but whether they will allow you to stop taking medicines completely depends on several factors:
The primary cause of your diabetesThe length of time that you had undiscovered, or "hidden," diabetes
The length of time you've had diagnosed diabetes
How well your pancreas is functioning, including how much insulin it is producing, and the extent of insulin resistance associated with excess weight
As you probably know, the cause of diabetes among most adults is twofold. It's caused by insulin resistance resulting from excess weight, and inadequate insulin production in the pancreas. These two causes are also interrelated. Many people whose diabetes is primarily the result of excess weight and insulin resistance can potentially reduce their glucose levels by losing a significant amount of weight and controlling their sugar levels through diet and exercise alone. This assumes that their pancreas is still producing an adequate amount of insulin.
A good number of diabetics, however, have the illness but don't know it for at least five years before diagnosis. This is crucial because over time, the insulin-producing cells in the pancreas decline in function. Often, by the time a patient is diagnosed, a critical number of cells have stopped producing insulin entirely. There is no way to reverse this. If your diabetes is diagnosed early in the disease process, however, aggressive management may help you prevent further loss of function in those cells. This means maintaining your fasting glucose levels below 100 mg/dl and your after-meal (two hours after) levels below 140 mg/dl. This is the same for morning and evening glucose levels.
It is also entirely possible for some people to control their blood glucose with diet alone. I have a few patients who have been able to do so. All are producing adequate insulin, have lost weight or are within their ideal body-weight range, and watch their diets.
— Mary, Wichita
A:It is wonderful that you are changing your lifestyle to become healthier! This will benefit you greatly, not only in controlling your blood sugar but also in improving your cholesterol levels, strengthening your bones, and improving your heart function. These changes come with a long list of health benefits, but whether they will allow you to stop taking medicines completely depends on several factors:
The primary cause of your diabetesThe length of time that you had undiscovered, or "hidden," diabetes
The length of time you've had diagnosed diabetes
How well your pancreas is functioning, including how much insulin it is producing, and the extent of insulin resistance associated with excess weight
As you probably know, the cause of diabetes among most adults is twofold. It's caused by insulin resistance resulting from excess weight, and inadequate insulin production in the pancreas. These two causes are also interrelated. Many people whose diabetes is primarily the result of excess weight and insulin resistance can potentially reduce their glucose levels by losing a significant amount of weight and controlling their sugar levels through diet and exercise alone. This assumes that their pancreas is still producing an adequate amount of insulin.
A good number of diabetics, however, have the illness but don't know it for at least five years before diagnosis. This is crucial because over time, the insulin-producing cells in the pancreas decline in function. Often, by the time a patient is diagnosed, a critical number of cells have stopped producing insulin entirely. There is no way to reverse this. If your diabetes is diagnosed early in the disease process, however, aggressive management may help you prevent further loss of function in those cells. This means maintaining your fasting glucose levels below 100 mg/dl and your after-meal (two hours after) levels below 140 mg/dl. This is the same for morning and evening glucose levels.
It is also entirely possible for some people to control their blood glucose with diet alone. I have a few patients who have been able to do so. All are producing adequate insulin, have lost weight or are within their ideal body-weight range, and watch their diets.
Thursday, January 20, 2011
Diabetes + Depression Increases Risk of Dying from Heart Disease
Depression and diabetes appear to be associated with a significantly increased risk of death from heart disease and risk of death from all causes over a six-year period for women....
Depression affects close to 15 million U.S. adults each year and more than 23.5 million U.S. adults have diabetes, according to background information in the article. Symptoms of depression affect between one-fifth and one-fourth of patients with diabetes, nearly twice as many as individuals without diabetes. Diabetes and its complications are leading causes of death around the world.
An Pan, Ph.D., of the Harvard School of Public Health, Boston, and colleagues studied 78,282 women aged 54 to 79 in 2000 who were participating in the Nurses' Health Study. The women were classified as having depression if they reported being diagnosed with the condition, were treated with antidepressant medications or scored high on an index measuring depressive symptoms. Reports of Type 2 diabetes were confirmed using a supplementary questionnaire.
During six years of follow-up, 4,654 of the women died, including 979 who died from cardiovascular disease. Compared with women who did not have either condition, those with depression had a 44 percent increased risk of death, those with diabetes had a 35 percent increased risk of death and those with both conditions had approximately twice the risk of death.
When considering only deaths from cardiovascular disease, women with diabetes had a 67 percent increased risk, women with depression had a 37 percent increased risk and women with both had a 2.7-fold increased risk.
"The underlying mechanisms of the increased mortality risk associated with depression in patients with diabetes remains to be elucidated," the authors write. "It is generally suggested that depression is associated with poor glycemic control, an increased risk of diabetes complications, poor adherence to diabetes management by patients and isolation from the social network." In addition, diabetes and depression are both linked to unhealthy behaviors such as smoking, poor diet and a sedentary lifestyle, and depression could trigger changes in the nervous system that adversely affect the heart.
"Considering the size of the population that could be affected by these two prevalent disorders, further consideration is required to design strategies aimed to provide adequate psychological management and support among those with longstanding chronic conditions, such as diabetes," the authors conclude.
Depression affects close to 15 million U.S. adults each year and more than 23.5 million U.S. adults have diabetes, according to background information in the article. Symptoms of depression affect between one-fifth and one-fourth of patients with diabetes, nearly twice as many as individuals without diabetes. Diabetes and its complications are leading causes of death around the world.
An Pan, Ph.D., of the Harvard School of Public Health, Boston, and colleagues studied 78,282 women aged 54 to 79 in 2000 who were participating in the Nurses' Health Study. The women were classified as having depression if they reported being diagnosed with the condition, were treated with antidepressant medications or scored high on an index measuring depressive symptoms. Reports of Type 2 diabetes were confirmed using a supplementary questionnaire.
During six years of follow-up, 4,654 of the women died, including 979 who died from cardiovascular disease. Compared with women who did not have either condition, those with depression had a 44 percent increased risk of death, those with diabetes had a 35 percent increased risk of death and those with both conditions had approximately twice the risk of death.
When considering only deaths from cardiovascular disease, women with diabetes had a 67 percent increased risk, women with depression had a 37 percent increased risk and women with both had a 2.7-fold increased risk.
"The underlying mechanisms of the increased mortality risk associated with depression in patients with diabetes remains to be elucidated," the authors write. "It is generally suggested that depression is associated with poor glycemic control, an increased risk of diabetes complications, poor adherence to diabetes management by patients and isolation from the social network." In addition, diabetes and depression are both linked to unhealthy behaviors such as smoking, poor diet and a sedentary lifestyle, and depression could trigger changes in the nervous system that adversely affect the heart.
"Considering the size of the population that could be affected by these two prevalent disorders, further consideration is required to design strategies aimed to provide adequate psychological management and support among those with longstanding chronic conditions, such as diabetes," the authors conclude.
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