Having Diabetes for a Decade Triples Stroke Risk

Having diabetes for a decade or more dramatically increases the risk for ischemic stroke 3% each year and triples at 10 years....

Senior investigator Mitchell Elkind, MD, from Columbia University Medical Center in New York, stated that, "We were not surprised to see an increased risk, but we were taken aback by how high the risk was."

Using data from the Northern Manhattan Study, investigators looked at 3298 multi-ethnic participants. They found that 22% had diabetes at baseline and another 10% went on to develop the disease over the course of the study. There were 244 ischemic strokes.

The authors explained, "Our study provides evidence that the risk of ischemic stroke increased continuously with duration of diabetes mellitus." "This was after controlling for other factors such as age, smoking history, physical activity, history of heart disease, blood pressure, and cholesterol."

"The increase is not as much during the second half of the first decade," they noted, "but it increases steeply as the disease enters its second decade."

Duration of Diabetes and Ischemic Stroke Risk
Diabetes (Years) Hazard Ratio 95% Confidence Interval
0 to 5 1.7 1.1 - 2.7
5 to 10 1.8 1.1 - 3.0
>10 3.2 2.4 - 4.5

Among the nearly 26 million Americans with diabetes, more than half are younger than age 65 years, according to the American Diabetes Association. Dr. Elkind said, "We used to think of type 2 diabetes as a disease people get when they are older, after a lifetime of poor dietary habits, but the age at diagnosis is getting younger and younger because of the obesity problem among young people."

The researchers pointed out that diabetes was determined by self-report in this study. "It's possible we missed some cases," Dr. Elkind added during an interview. An estimated one third of diabetes cases may be undiagnosed. It has also been found that true onset of diabetes may be 4 to 7 years earlier than clinical diagnosis.

As the population ages and the elderly live longer, more and more people will live with longer duration of disease, the authors note. "It is important to better understand the dynamics between diabetes, time, and stroke, and to emphasize the importance of interventions to prevent early diabetes. Minimizing the number of years a patient has diabetes would help combat the increase in stroke risk with each year of the disease."

Some of the reasons for increased stroke risk may include an association between longer diabetes duration and thicker plaque in neck arteries and the higher prevalence of hypertension, accelerated vascular complications, and clotting abnormalities.

WWE Legend Kamala Loses Foot To Diabetes

WWE legend Kamala is at risk of losing another foot due to his diabetes-related medical problems -- this according to his son.

As TMZ previously reported ... Kamala’s left leg was amputated last year due to ongoing complications with diabetes and high blood pressure. Unfortunately the problems aren’t over.

Kamala Jr. went on "The Roman Show" today and revealed, “[My father] is havingcomplications with his other foot now ... Friday we’ll know if they have to take his other foot off.”

Seinfeld Actor Survives After Shooting Self in Head

Seinfeld actor Daniel von Bargen, who's best known for playing George Costanza's boss Mr. Kruger in the sitcom, is in critical condition after a failed suicide attempt earlier this week, TMZ reports.

The 61-year-old was in his Cincinnati apartment Monday morning when he shot himself in the head and then called for help. According to audio of the 911 tape posted on the gossip site, he told the operator, "I've shot myself in the head and I need help."

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The gunshot to the temple was not an accident. Von Bargen, who is a diabetic, recently learned some bad news. "I was supposed to go to the hospital and I didn't want to. So I shot myself... They were supposed to amputate at least a few toes."

Von Bargen was transported to a nearby hospital.

The veteran actor also recurred as Commandant Edwin Spangler on Malcolm in the Middle. On the big screen, he's appeared in O Brother, Where Art Thou?, The Faculty and Super Troopers.

CDC: Big Drop in Diabetes Amputations

65% Lower Rate of Foot, Leg Amputations in Just Over a Decade

Jan. 24, 2012 -- There has been a dramatic drop in the rate of diabetes-related amputations in the U.S., and experts attribute the improvement to better management of risk factors that lead to the loss of feet and legs.

The amputation rate declined by 65% among adults with diabetes in a little over a decade, the CDC reports.

Foot and leg amputations occurred in 4 out of every 1,000 adults with diabetes in 2008, compared to 11 out of every 1,00 in 1996, the CDC reports.

Non-injury-related amputation rates were still eight times higher among those with diabetes than adults without the disease.

Nevertheless, the decline shows that efforts to reduce the complications of diabetes are having a major impact, says American Diabetes Association President of Medicine and Science Vivian Fonseca, MD.

“This is very encouraging and important news for people with diabetes,” he says. “The decline confirms the tremendous progress we have made in translating research into practice."

What Your Feet Say About Your Health

Diabetes-Related Amputations Down

Nerve damage or neuropathy is a common complication of diabetes, especially among people who have had the disease for many years.

Poor control of diabetes, such as prolonged high blood sugar, low insulin levels, and high blood pressure, are believed to be major contributors to diabetes-related nerve damage.

According to this new study, foot and leg amputation rates serve as an important gauge of the effectiveness of efforts to reduce diabetes complications by controlling these risk factors.

Researchers analyzed data from two national surveys to determine the prevalence of diabetes-related leg and foot amputations in adults aged 40 and over.

Among the major findings:

· Between 1996 and 2008, the rate of leg and foot amputations among adults with diabetes declined by 65%, with men having three times the rate of amputations as women (6 per 1,000 vs. 2 per 1,000).

· Amputation rates were higher among blacks than whites (5 per 1,000 vs. 3 per 1,000).

· Those over the age of 75 had the highest rate of amputations.

The study will appear in the February issue of the journal Diabetes Care.

Keep a Close Eye on Your Feet

While the decline is encouraging, CDC epidemiologist Nilka Rios Burrows, MPH, says much more could be done to reduce amputation rates among diabetic people.

“The message to patients and their doctors is that addressing the modifiable risk factors for diabetes complications can have a huge impact,” she says.

That means aggressive medical management of blood pressure, blood sugar, and cholesterol, maintaining a healthy lifestyle, and keeping a close eye on your feet.

“A foot exam should be part of every medical visit,” Burrows says. “If the doctor doesn’t mention it, the patient should. And people with diabetes should check their own feet every day to look for sores or injury.”

Other recommendations for diabetic people from the CDC’s National Diabetes Education Program include:

· Wash your feet every day, keep feet soft with lotion or petroleum jelly, smooth corns and calluses gently, and trim toenails frequently.

· Wear shoes and socks at all times to minimize the risk of injury.

· Protect feet from extreme heat and cold.

· Remain active and do other things to promote blood flow to feet.

· Discuss foot care with your doctor.