Most diabetes amputations 'preventable'

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."

Lowering Fat Intake Might Stave off Diabetes Even without Weight Loss

Small differences in diet -- even without weight loss -- can significantly affect risk for diabetes....

In this study, 69 healthy, overweight people who did not have diabetes -- but were at risk for it -- were placed on diets with modest reductions in either fat or carbohydrate for eight weeks.

Barbara Gower, Ph.D., professor in the Department of Nutrition Sciences at University of Alabama at Birmingham and lead author of the study noted that, "At eight weeks, the group on the lower fat diet had significantly higher insulin secretion and better glucose tolerance and tended to have higher insulin sensitivity." "These improvements indicate a decreased risk for diabetes."

Gower says the unique aspect of this study is that the results were independent of weight loss.

The study participants were fed exactly the amount of food required to maintain their body weight, and the researchers took into account any minor fluctuations in body weight during analyses. Thus, results from this study suggest that those trying to minimize risk for diabetes over the long term might consider limiting their daily consumption of fat at around 27 percent of their diet.

"People find it hard to lose weight," said Gower. "What is important about our study is that the results suggest that attention to diet quality, not quantity, can make a difference in risk for type 2 diabetes."

The findings were even stronger in African-Americans, a population with an elevated risk for diabetes. Gower says African-Americans on the lower fat diet showed a stronger difference in insulin secretion compared to the lower carb group, indicating that diet might be an important variable for controlling diabetes risk in that population.

Study participants in the lower fat group received a diet comprising 27 percent fat and 55 percent carbohydrate. The lower carb group's diet was 39 percent fat and 43 percent carbohydrate. All food for the eight-week trial was provided by the study.

"The diets used in this study were actually fairly moderate," said UAB dietitian Laura Lee Goree, R.D., L.D., a study co-author. "Individuals at risk for diabetes easily could adopt the lower fat diet we employed. Our findings indicate that the lower-fat diet might reduce the risk of diabetes or slow the progression of the disease."

A typical dinner meal on the lower fat diet would include sesame chicken with rice, snow peas and carrots, frozen broccoli, fat-free cheese, oranges and a dinner roll.

Gower says further research is needed to determine if the difference between diets in carbohydrate or fat was responsible for the differences in the measures of glucose metabolism and probe the potential cause-and-effect relationship between insulin and glucose responses to the diets.
Published online May 18, 2011, by the American Journal of Clinical Nutrition