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With diabetes, save a leg, save a life
April 8th, 2011
05:52 PM ET

With diabetes, save a leg, save a life

 

Each year in the U.S. diabetes results in the amputation of about 65,700 legs or feet. About 85% of those began with a diabetic foot ulcer. And for Dr. David Schwegman, the mission to educate people about the issue is personal.

His father, a diabetic, had a foot ulcer that resulted in the amputation of his left leg, which contributed to his death, his son said.

"He became a statistic," Schwegman said. "He was one of the 50% of people that died within five years after having an amputation."

Diabetic foot ulcers, or DFUs, are usually located on the ball of the foot, the bottom of the big toe or sides of the feet. They can be a result of neuropathy, or nerve damage which leads to a loss of feeling.

Although prevention is key, simply not treating an ulcer can lead to infection, particularly in the bone, and eventual loss of a limb.

"If you have a DFU that leads to a major amputation, your risk of death in five years is greater is higher than that of breast cancer and prostate cancer combined," Schwegman said.

"This is a very, very serious health problem that has very serious risks if not dealt with properly and quickly," the doctor said. "In order to do that, we really need to get the word out to both the patients and the physicians."

That's where the Save a Leg, Save a Life Foundation , or SALSAL, comes in. On Saturday, Schwegman, along with the Atlanta chapter of the national group, are offering free foot screenings as part of the American Diabetes Association's Health Expo.

You can find an expo near you by visiting the American Diabetes Association's calendar for 2011. Diabetics can be screened for cuts, blisters, discoloration of feet, and any signs of bacteria or infections, conditions that can lead to foot ulcers.

Right now, 18.8 million adults and children in the U.S. have diabetes. The Centers for Disease Control and Prevention estimates that 7 million people have undiagnosed diabetes and 79 million are prediabetic.

Diabetics need to know that treating the ulcer early is the best way to get  it healed.

"If we're not treating them aggressively, the chances that they heal is actually very, very low," Schwegman said.

An important part of the evaluation of a person with a diabetic foot ulcer is a thorough vascular exam, since diabetics have a higher risk of having peripheral arterial disease. The condition results when circulation to the legs and feet is blocked or narrowed by calcifications. The poor blood flow can cause pain and discoloration in the feet- an increase in a red color, a dusky bluish color or sometimes the toes turn black and result in amputation.

Dr. Desmond Bell, a wound care specialist and founder of SALSAL, recommends going straight to a podiatrist or wound care specialist if a cut, sore or wound does not heal in a week or two. Those with a history of diabetic foot ulcers should see a specialist immediately.

Bell said several newer treatments are available to treat these wounds. None are a "silver bullet" for every single wound.

SALSAL hopes to educate both physicians and the general public about them in order to prevent unnecessary amputations. Of the thousands of products available, only these three have evidence that they have increased wound healing rates:

-Advanced skin cell substitutes include Dermagraft and Apligraf. These are similar in that they are derived from neonatal foreskins.
-A growth factor gel, Regranex.

Hyperbaric oxygen therapy can also heal wounds and treat infections.

Most exciting, Bell said, is peripheral revascularization, in which cardiologists and others, go into the groin similar to an angioplasty for the heart. Through this new procedure, doctors can open up blockages in the leg and restore blood flow.

"It requires lots of doctors often times and it requires a motivated patient," Schwegman said. "By saving their leg, it really does save their life."


soundoff (66 Responses)
  1. Cath Lab Tech

    Angioplasty to treat peripheral vascular disease is a new technology? So what was it when we were doing it 10 years ago ? Balloon angioplasty is a temporary fix, as are stents, lasers, and a dozen other technologies that have been attemped over the years to keep the peripheral arteries patent. A little fact verification would have been good here CNN...

    April 8, 2011 at 21:00 | Report abuse | Reply
    • Desmond Bell

      Thanks for your input. Sadly, these technologies are underutilized. Yes, modalities such as angioplasty, stenting and atherectomy have been in use for some time, but many patients are not receiving access to these tools. Allie, Walker, et al, found that around 50% or more of lower extremity amputations occur without even a simple non-invasive vascular evaluation.
      I ask you, where is the accountability? The general public is truly not aware of the options, and a true lack of understanding as to what P.A.D. really is exists. If we can reduce lower extremity amputations by 25%, we could save the US Healthcare system approximately 3-4 $ Billion annually.

      April 9, 2011 at 13:28 | Report abuse |
    • Desmond Bell

      One other point here. Yes, the patency rate of vessels opened via endovascular methods may not be as high as traditional bypass surgeries of the lower extremity, but not all patients are bypass candidates. Nothing more gratifying than helping heal a wound and preventing a major amputation in someone who has previously only been offered amputation. If that were you in the treatment chair, and someone offered you 30% chance versus 0% chance at preserving your leg, would you take it? What if it were a loved one? "Temporary fix" is certainly preferable to NO FIX! Amazing what we can heal with increased blood flow. Pain level also tends to decrease dramatically post-intervention. I have seen enough in my career that I would not wish severe P.A.D. (Critical Limb Ischemia) on my worst enemy!

      April 9, 2011 at 13:42 | Report abuse |
    • runswithbeer

      It's not the loss of the limb that causes death in five years, it's the ineffective treatment for the underlying cause,diabetes. The underlying cause for diabetes is depression. Depression caused by overeating of processed Carbohydrates. I know, I have this disease.

      April 9, 2011 at 18:43 | Report abuse |
    • Todd

      So your choices are either lose weight or get the end of a baby's penis attached to your feet...

      Have another cookie...

      April 10, 2011 at 02:42 | Report abuse |
  2. libprovider

    Americans need to stop getting fatter by the nanosecond & Diabetes rates will go down...

    April 8, 2011 at 21:43 | Report abuse | Reply
    • Sash

      Your extensive knowledge of the pathophisiology of diabetes is astounding. It's also quite wrong.

      April 8, 2011 at 23:05 | Report abuse |
    • informed

      You are ignorant. I'm sad for you. Your world must suck.

      April 9, 2011 at 01:42 | Report abuse |
    • 5-HT

      Not sure how the two of you can challenge the notion that losing weight reduces the risk of developing T2 diabetes. That's a simple fact. Lowering your Food intake means a smaller periphery and lower fasting blood glucose. That means your pancreas secretes less insulin and the cells in your body will not develop insulin resistance.

      Type 1 and 1.5 are not something people can control. But Type 2 is almost entirely preventable through healthy eating and exercise.

      OP is correct.

      April 9, 2011 at 10:18 | Report abuse |
    • Type 1 Diabetic

      Hey dude,

      Just so you know, I am 6'7", 215, eat very healthy, I ran my first marathon last year and I have type 1 diabetes. Out of my control. But to everyone who reads this....try mixing it up. Every morning I eat 1 of the following: Ginger / Blueberries / honey, blended with water, drink. Or Cayenne with Honey and water, drink. This helps circulation and overall health. Try for yourself. It is hard to get used to as these are very strong herbs.

      April 9, 2011 at 17:54 | Report abuse |
    • dmknow

      I work in a hospital and many of the amputations I see that are caused/related to diabetes are not necessarily on overweight people. Often this happens to the elderly as well as normal weight people with diabetes (not to mention the underweight and malnourished people I see). Being overweight really has nothing to do with it.

      April 9, 2011 at 22:10 | Report abuse |
    • A

      I have diabetes and I am 5'9 and 125 lbs. Stop being ignorant.

      April 9, 2011 at 22:18 | Report abuse |
    • Todd

      THere are 2 types of diabetes. THe type related to obesity (type II, I think) would go down. Type 1 is unrelated to weight, and is more inherited.

      April 10, 2011 at 02:43 | Report abuse |
    • Leo

      I'd wager that "libprovider" is referring to Type 2 diabetics in his comment, not type 1. I have three friends who have type 1 diabetes (including one who was diagnosed at the age of six while we were classmates in first grade) and I am well aware that type 1 and type 2 are completely different diseases.

      People with two brain cells to rub together are aware that type 1 diabetes is an autoimmune condition where the body destroys the Islets of Langerhans cells in the pancreas, thereby permanently destroying the body's natural ability to produce insulin. This is something that is beyond the person's control, is independent of diet and fitness level, often happens to young children who appear perfectly healthy, and can kill the patient within days if it isn't treated quickly.

      Although some people are more genetically prone to type 2 diabetes than others... the VAST MAJORITY of type 2 diabetics develop the condition as a result of poor diet and lack of exercise. In other words... they're fat and lazy. Sorry, the truth hurts. It's actually rather pathetic that our system ENABLES this disease, rather than telling people that they MUST change their lifestyles. Oh, perish the thought! How dare we tell people that they have to take care of themselves! Instead, let's have insurance companies and Medicare foot the bill for billions of dollars worth of testing equipment, drugs, and supplies for people who won't take care of their health. The only truly sad thing is that the folks with Type 1 diabetes are being falsely lumped into the "fat and lazy diabetic" stereotype by people who don't know any better.

      Cheers. No go eat a carrot and take a walk.

      April 12, 2011 at 14:48 | Report abuse |
  3. patty

    Plain old Niacin seems to help a lot too. And in the big scheme of things, it's remarkably cheap.

    April 8, 2011 at 22:53 | Report abuse | Reply
  4. VitaminK2

    If you don't know about vitamin K, then Google this: "calcification vitamin k"

    April 9, 2011 at 04:52 | Report abuse | Reply
    • Todd

      Vitamin K helps promote healthy clotting of blood. I don't think that is the issue here.

      April 10, 2011 at 02:44 | Report abuse |
  5. Jacques LeDoux

    My cousin died from complications due to diatbetes. After Ice Fishing here in Minnesota he noticed his big toe had discolored (must have been a touch of frostbite and he had neuropathy in his feet – lack of feeling). Well things got worse and his toe turned black and had to be amputated. Within 6 months the doctors had to remove his foot above the ankle and within a year my poor unfortunate cousin was dead (age 51). I keep my diabetes in check by riding bicycle, it's the best exercise for diabetes you can find, however, in Minnesota snow up to your a** is very common and it's hard to ride 7 months out of the year so I go to the "club" and run the treadmill and swim which is not nearly as good as bicycling.

    April 9, 2011 at 08:09 | Report abuse | Reply
    • Galina L

      Dr.R. Bernstein's book "The Diabetic Solution" is available on-line for free. Without low-carb diet there is no help. Bicycling is not enough.

      April 9, 2011 at 18:01 | Report abuse |
  6. Sandy

    NO DIABETIC NEEDS TO LOSE A LEG OR A FOOT. A FILMMAKER HAS BEE REVERSING DIABETIC FEET AND SAVING THE LEG (WITHOUT MEDICATIONS)

    just google SPIRIT HAPPY DIET...

    April 9, 2011 at 09:10 | Report abuse | Reply
    • Todd

      Until it is fully tested and verified, I'll pass. You do the faith healing.

      April 10, 2011 at 02:45 | Report abuse |
  7. jack rugby

    Just visit drfuhrman dot com. Sadly Americans want to eat the crap that the TV set pitches. Dr Fuhrman can help you but it takes self control.

    Dr Fuhrman has written a number of books – maybe you can borrow them at your library. His point is that your body is its best doctor when it comes to diabetes, heart disease, arthritis and so forth. He will get you off those drugs that the regular big pharma pill pushers insist is the only way to survive. What you eat is the key.

    April 9, 2011 at 10:42 | Report abuse | Reply
  8. Ann

    Please provide references for your reported information. I've never heard that calcification is the reason for poor blood circulation in diabetics. My understanding of diabetes-related poor blood circulation, peripheral neuropathy, and subsequent cause for amputation is that high sugar in the bloodstream acts like a corrosive, thinning and eventually causing most vulnerable small blood vessels in peripheral body members (feet, legs, hands) and in the kidneys to burst. With the resulting diminished blood circulation and kidney function, the body cannot effectively fight infection very well. As well, nerves lacking sufficient blood supply die, and without sufficient feeling sensation, injuries of any sort can become much worse since the person may not feel to know that an injury or infection is festering until it's too late.

    April 9, 2011 at 12:01 | Report abuse | Reply
    • Desmond Bell

      The arteries do in fact become calcified over time. As atherosclerosis progresses, we can actually see arteries on x-rays of the feet and legs (you will not see this in healthy vessels). On numerous occasions during surgery (usually partial foot amputations), I have encountered calcified vessels where the disease has rendered them to the point they are bone-like in their consistency. Surgical instruments literally create a "clicking" noise as metal contacts calcified arteries.

      April 9, 2011 at 13:20 | Report abuse |
    • Elizabeth

      I do not have diabetes, but I have calcification problems, not in the arteries but in tendons. Most doctors just expect this to go away by itself; some doctors prescribe physical therapy. However, my blood tests show high sedimentation rate and CRP, but without rheumatoid factor, so I was put on a drug that lowers my immune system. (But, they didn't try to find out if I have an infection somewhere.) I get every cold and flu; I'm home right now with a fever and too sick to do much. I also have another condition that most people ignore: endometriosis and adhesions, for which I've had several surgeries. I've found that simply putting a regular pillow under my lower legs at night helps my legs feel better in the morning and not be discolored or swollen, although with or without the pillow, it is sometimes everything I can do to walk when I first wake up because my legs and feet are so stiff and painful. Sometimes there isn't much that can be done; I appreciate doctors helping me, and some have been wonderful, but most of them won't go the first mile, much less the extra mile, to try to figure out illnesses.

      April 9, 2011 at 20:34 | Report abuse |
  9. A. Alicia Dobrowolski-Sogor

    I literally experienced a similar scenario with my mother, at this time last year; at 84, and years of Type II diabetes, I had to struggle over the decision to amputate her left leg, above her knee (BK).That was the only choice given at that time...I chose as best as I could, researched as best as I could, and wished it had all been a bad dream...But amputation was a choice we did not want. Her right toe had a slight bruise, and things moved quickly, from March, till her death in June...After her diabetic diagnosis in her early seventies, we rarely strayed from her diabetic diet, and we walked when we could...Diabetes is preventable. I wish for various reasons I could have been offered other choices, for my mother-she was not a candidate.

    April 9, 2011 at 16:10 | Report abuse | Reply
    • Galina L

      Unfortunately, the Diabetic Diet recommended by ADA contains too much carbohydrates and makes BS control impossible.

      April 9, 2011 at 18:05 | Report abuse |
  10. iminim

    Unfortunently, many people with diabetic foot lesions only seek medical care when infection has entered the wound and reached the bone or when they begin to have systemic symptoms like fevers, chills, or other signs of "sepsis" (infection spreading into the bloodstream and around the body with resulting severe infection. At this point amputation is sometimes the only way to stop the infection. There are some measures that diabetic patients care take to help protect themselves from developing an ulcer or to detect one early when it is easier to treat.

    1) Look at your feet, using a mirror if necessary, every time you put on or take off shoes. If you see a red spot, blister, scratch or other skin wound observe it closely. It it worsens, seek medical help. If your vision is not good, ask a family or friend to help you check your feet.

    2) Never cut into your callouses or corns. If you have an area on your foot that is uncomfortable, check it out with your doctor.

    3) Make sure your doctor checks your feet when you have a physical exam. Remind him/her to do it if they don't do it routinely.

    4) Check you shoe soles for objects that could penetrate the soles before you put the shoes on. You might have stepped on a tack or other sharp object & not felt it. Be sure to also run your hand down into your shoes & make sure there are no wrinkles in the lining or rough spots that could blister your foot.

    5) If a shoe has been damaged or does not fit your foot do not wear it. Get rid of it.

    6) If you have poor feeling on your feet, do not dry them off by rubbing with a towel. Pat them dry with the towel instead.

    7) Do not go barefoot, especially outside.

    8) Wear well fitting shoes and socks. If your feet have become deformed due to severe diabetes or prior amputations of toes, ask your doctor for a referal to a podiatrist who is able to fit you for orthotic shoes that correctly support your altered foot shape.

    Remember, it is far easier to prevent foot ulcers than it is to heal them.

    April 9, 2011 at 16:45 | Report abuse | Reply
    • iminim

      I have no idea how that smiley face got into my comment. I do not consider diabetic foot lesions to be a funny topic at all.

      April 9, 2011 at 16:51 | Report abuse |
    • Stephen

      * raises hand* I know, I know! It was an honest mistake, my friend. You hit the colon key instead of the number 8, and hit the parenthesis key, which makes the smiley face.

      April 9, 2011 at 18:43 | Report abuse |
  11. MikefromWV

    As a type II diabetic with diabetic neuropathy in both feet, I can attest to it's ill effects. But, when you live on a fixed income it is often more difficult to try and maintain a proper diet, as you can't afford to buy the requisite food.

    April 9, 2011 at 17:10 | Report abuse | Reply
    • Galina L

      Research your diet options more carefully. You don't need fruits at all, just veggies. Eat 2- eggs with butter for your breakfast -you will be full till lunch. Chicken and pork are very affordable. Ditch all grains and starches. Saving your legs is more important then eating sugars in different forms.

      April 9, 2011 at 18:12 | Report abuse |
  12. Carla in Jacksonville

    I am a 39 year Type 1, my grandfather was an amputee and it did not make the pain go away. It created another world of problems. As a patient of Dr. Bells, I can attest that good foot wound care and stenting is well worth it. It has definitely saved my legs and my life. I am now capable of walking a mile and a half a day. Until you have walked the walk you can't say what you would do.

    April 9, 2011 at 18:25 | Report abuse | Reply
  13. anom

    i dunno even then Justin Bieber is a barbie, by his DNA he is genetically engineer to make money of people, by using a program called GEODNACLONING&ALIENGENETICS. This program is built by a secret government agency. To use humans as test subjects to learn from the human race how a human works interacts, like, dislikes, and so on. As far as my knowledge extends I have acquired alot of intel of this program called GDC&AG. The program has many features and functionalities. One amazing tool the Genetic Engineers have develop and fixed over the last decade is the like panel. This panel or User Interface has the power to mind control humans to like stuff whether it has value or no value at all. This program also has cloning capabilities to clone anything of any matter, or objects even the Planet Earth. As far as my intel goes I dont know what power does GDC&AG holds, What I do know is that the Government is holding alot of secrets in many areas of studies such as Weaponry, Medical, & Space&Universal Technology. The reason I’m speaking out, and spreading the word about the program and studies of the Government. The like Panel is causing, defects and abnormalities to humans, My studies show that the program is effecting the frontal, parietal, occipital, temporal lobe. Causing Headaches, Abnormal love or like to anything of value or like, to a point where the frontal lobe is slowing being destroyed by the Program Waves, Reasoning, Unresponsive, Anger, this symptoms effect anyone whom come across any technologies engineered by the Government Agency. One example is the Genetically Engineered Justin Bieber transmitting the program waves through telepathically thoughts, through Videos, more products are being develop in secret facilities and being distributed in many ways. The Goverment wants full control over the human race, to perfect the Human and have control of every being by developing products for all humans of likes and dislikes. Another Example is Youtube engineered by GDC&AG, to give a head start in human control. One more thing, all these Wars are the cause of the Program. You don’t have to believe in this , or think its true the Goverment already has integrated a micro bug in all lobes of the brain to see this message as a lie, the bug is being transmitted through telepathy using products to spread.

    April 9, 2011 at 21:06 | Report abuse | Reply
  14. Sandy

    NO DIABETIC NEEDS TO LOSE A LEG OR A FOOT. A FILMMAKER HAS BEE REVERSING DIABETIC FEET AND SAVING THE LEG (WITHOUT MEDICATIONS)

    just google SPIRIT HAPPY DIET

    April 9, 2011 at 22:01 | Report abuse | Reply
  15. kevin

    If circulation is the issue, the article could have mentioned exercise that gets the heart rate up. The people who I know with T2 diabetes, and one with a leg amputation that lead to death, were extremely sedentary and in their 60s.

    April 10, 2011 at 00:21 | Report abuse | Reply
  16. kl

    i have been trying to post a comment and there seems the site seems to be censoring my comments since they are not appearing. i don't understand why since my comments only seek to clarify the problem with diabetes and leg wounds.

    April 10, 2011 at 01:16 | Report abuse | Reply
  17. wound doc

    the most important aspect of wound healing in diabetics is restoration of blood flow and control of infection. Most diabetics have poor blood flow to their legs due to blockages in the arteries. Restoration of blood flow is generally treated by a vascular surgeon rather than a cardiologist as the article indicates. In addition to angioplasty, a vascular surgeon can perform bypass when the blockage is too severe to open with angioplasty alone. Exercise to get the heart rate up would not improve their circulation since there is a physical obstruction to the blood flow. In fact, stressful exercise can lead to severe pain in the legs known as "claudication," a kind of heart attack of the muscles in the legs. Furthermore, the blockages present in the legs are likely also present in the heart and stressful exercise could lead to heart attack.
    since blood flow is so critical to wound healing, these patient should be seen by a vascular surgeon and a wound care expert as well as a plastic surgeon skilled in reconstruction since often these patients are left with exposed bones and tendons which will need to be covered with tissue.

    April 10, 2011 at 01:22 | Report abuse | Reply
    • Desmond Bell

      Vascular surgeons, Cardiologists and Radiologists all have the capability to provide endovascular intervention (angioplasty, stents, atherectomy, laser). The key is finding the right specialist with the mindset and skill set who is able to use multiple modalities to open occluded vessels and who is not so quick to recommend amputation without testing or even referral to another specialist who has the capability to open vessels beyond the level of the knee and into the leg or even foot.
      Thanks for mentioning the correlation between heart attack. "Save A Leg, Save A Life" refers not only to reduction of amputation, but also the correlation between heart attack, stroke and the complications of diabetes and Peripheral Arterial Disease.

      April 10, 2011 at 09:06 | Report abuse |
  18. siddharth

    does sodium piconate help with diabetes and insulin resistance? what is the absolute safe dosage of sodium piconate ,that one can take?
    thanks

    April 10, 2011 at 07:47 | Report abuse | Reply
  19. john

    A guest doctor on your program special this morning stated that ethyl alcohol is a sugar. This is an inaccurate statement that you should refudiate. When alcohol is consumed its metabolisim decreases the livers ability to produce glucose from fat and your blood sugar level will "FALL" ,not be increased, for up to 2 hours per 1 oz of 86 proof. Diabetics run the risk of hypoglycemia–especially if on medication

    April 10, 2011 at 08:52 | Report abuse | Reply
  20. adrian

    know more....about diabetes

    April 10, 2011 at 13:06 | Report abuse | Reply
  21. Steve

    This is nasty!!!

    April 10, 2011 at 13:22 | Report abuse | Reply
  22. Steve

    I read a few weeks ago some idiot had his toes chewed off by his dog when he slept cuz he had diabetes. Thats nnnnnnnnnnnnnnnnnnasssssty!!!!!

    April 10, 2011 at 13:25 | Report abuse | Reply
  23. Mary

    Interesting facts and story on diabetes. CNN does a good job on health care stories. I just read a really good medical book, of true-life stories from the ER, called "Stories from the Emergency Department". Fun read.

    April 10, 2011 at 15:52 | Report abuse | Reply
  24. Mack D Jones, MD

    I am surprised that there is no mention of obstructive sleep apnea (OSA) in diabetics. Over half of type 2 diabetics have it
    Treatment with CPAP has reversed early disease and in those with long standing disease, treatment can dramatically improve their overall status. (not to mention prevent numerous other medical complications). Every diabetic should have a sleep study and be treated when positive for OSA.
    Check out "Deadly Sleep," Is Your Sleep Killing You? It is an informational booklet on OSA, its complications, and treatment.

    April 10, 2011 at 22:17 | Report abuse | Reply
    • Desmond Bell

      Thanks Dr. Jones, for addressing another one of the complications diabetics deal with. While the focus of this article was focusing on diabetic and lower extremity ulcers relating to P.A.D., you have helped us to further "connect the dots" by calling attention to another diabetic related issue. Point here is that diabetes has an effect on every system in the body. This is a great topic for further discussion within our "SALSAL" Chapters and even for our National meeting. "Save A Leg, Save A Life" is about not only reducing lower extremity amputations, but also helping to prevent catastrophic events, such as heart attack and stroke. Sudden death and heart failure from sleep apnea certainly falls into this category. Please contact us through our website, if interested in discussing a bit more.

      April 11, 2011 at 12:03 | Report abuse |
    • Leo

      Hey "Doc,"

      They didn't mention sleep apnea in this article because... *drumroll*... the article wasn't about sleep apnea. It was about circulatory issues and poor wound healing in patients with diabetes. Try to keep up.

      April 12, 2011 at 14:52 | Report abuse |
  25. Younan MarketingAnd Management Associates Inc, Int'l Intst'r

    IN an angioplasty do you go in with a tube and then hammer something(resembling a big nail) in their chest and then radioactively set them on fire like you did to my head with the same procedure in an angiogram? Is that how that magic trick works. looks like the same hocus pocus stuff. And for the next performance the doctor would say i will be turning you into a
    jack-o-lantern, and it will be halloween the rest of your life. and in our new advanced approach to health care when you are 6 months away from being born we will administer 7vaccines through the placenta. and after birth after we smack you on the ass to make you scream we'll give you 8 more vaccines to make sure you are cripple at least part of the time as you grow up. then the next magic performance to prove i am your very life blood to depend on i'll make sure your mother is poisoned enough so she is vomiting all day and can't feed you and has to order take out. i guess back to the basement again.

    April 10, 2011 at 23:53 | Report abuse | Reply
  26. Evan W. Lipstein

    Our company Creative Safety Solutions offers a telescoping and magnifying mirror that enable diabetics to regularly inspect the soles of their feet for foot ulcers. The mirror has a built in light and a method to measure the size of ulcers. This type of mirror is a necessary tool so diabetics can perform daily foot examinations for color changes, spots, sores, lesions and foot ulcers. Every Diabetic should own a foot mirror. http://www.diabeticfootmirror.com

    April 15, 2011 at 08:59 | Report abuse | Reply
  27. Ron Renzi

    Amputations in the US have been going down since 1997. The article states there are 65,000 amputations of feet and legs. This is an old statistic. The Agency for Healthcare Quality and Research (AQHR) counts these procedures. There were a little under 40,000 in 2009 with a diagnosis of diabetes.

    May 19, 2011 at 17:37 | Report abuse | Reply
  28. Cheryl

    I live in Jacksonville, Fl I have been told I need to have a partial foot amputation. I would like to get in touch with Dr. Bell. I don't feel as though I have had great wound care, if any. Please notify me if possible. I am fighting this amputation with all life.
    Thank You!

    May 23, 2011 at 16:07 | Report abuse | Reply
    • Family5602

      Hi, I know it's been a super long time since you posted this, but if you still need help or know someone who wants to avoid amputation – this company saved my husbands leg. Get in touch. http://CureCare.com

      February 7, 2014 at 21:37 | Report abuse |
  29. cj

    Someone mentioned that amputation was the only option when an infection gets in the bone and that is not true. Hyperbaric oxygen therapy is approved to treat osteomylitis and insurance covers the use of this treatment. Sadly many patients are not given all the facts. Not all patients are candidates, but for many this could save their limb and their life.

    September 15, 2011 at 19:32 | Report abuse | Reply
  30. The Leg

    i find it hard why doctors opt to amputate a leg when it can still be saved.. I've seen one that the doctor wants to amputate it but the px didn't want it and went to alternative ways.. The cure was as easy as A B C.. Sink the foot on warm water for 10-15 minutes but cover the wound, after that dress it with a pure honey or a poisonous grated sweet potato.. just remember to control the sugar. spread this news and save a leg and the money

    December 17, 2011 at 21:13 | Report abuse | Reply
  31. Laurie Endicott Thomas

    To protect your feet, cure your type 2 diabetes: http://wheredogorillasgettheirprotein.blogspot.com/2011/12/to-protect-your-feet-cure-your-type-2.html

    December 20, 2011 at 20:48 | Report abuse | Reply
  32. dukan diet book

    I will right away grasp your rss as I can not to find your e-mail subscription link or e-newsletter service. Do you've any? Kindly permit me recognize in order that I could subscribe. Thanks.

    April 4, 2012 at 11:50 | Report abuse | Reply
    • Bonita

      Yes.Those symptoms only occur dunrig high blood sugar.However, low blood sugar comes with other symptoms: shaking, mood swings (personally, i have to fight back tears xD), nervousness, extreme fatigue, desperate hunger, fogginess, dizziness, sweating. Those are my symptoms but other people experience other things.Low blood sugar is MUCH more noticeable than High Blood sugar, you only usually have high blood sugar symptoms when you're above 300.

      May 24, 2012 at 10:45 | Report abuse |
  33. Saira

    My eleven year old dehautgr has type 1 diabetes. She was diagnosed at the age of 8. She has been on the insulin pump for 2 1/2 years. Her daily routine starts with testing when she first awakens (about 6:30), followed by breakfast. She enters her blood glucose (BG) and the number of carbs she will eat into the pump and it calculates how much insulin she needs to cover these. At 10:00am she tests again to see if her number is good and either corrects (through the pump) or has a snack to elevate her BG if she is a little low.She tests again at lunchtime (about 11:45) and repeats the process from breakfast. She tests a 4th time after school, (3:00ish) to see where her BG is. If she is participating in an after school sport she will need a snack to keep her BG up with the extra activity. At dinner time (roughly 6:00) she will repeat the testing and enter into the pump her BG and carbs. She tests for the 6th and last time (usually) at bedtime.The pump holds insulin in a tube called a resevoir and delivers the insulin through a tube to a canula called an infusion set that is inserted under the skin of her abdomen area. The infusion set and resevoir need to be changed every 2-3 days and is done at home by me.She sees her pediatric endocronoligist every 3 months for an HbA1c test, height/weight etc and to monitor how well she is managing her BG.This is our typical daily routine. Which is subject to change at any time as her BG is affected by: an increase in physical activity, illness, stress, problem with the pump or set, etc etc

    May 23, 2012 at 20:59 | Report abuse | Reply
  34. Sheena

    Amputation is a scary thought. But I believe people should know. There are a lot of information about diabetes on the market place that could perhaps prevent this situation.

    November 19, 2013 at 08:31 | Report abuse | Reply
  35. MikeAguilarRadio.com

    My husband is type 2. Got a foot ulcer, and partial foot amputation with a lot of pressure from docs and not much else by way of options. When it took forever to heal, it got infected and the docs again said cut it off. I said no, and looked around. I luckily found a company that offered an out of pocket but completely natural and safe treatment that closed my husbands foot wounds 100% within 8 weeks. The docs thought they would NEVER close. The company was http://curecare.com Look them up – they have saved many patients from amputation.

    February 7, 2014 at 21:31 | Report abuse | Reply
  36. abpdermal

    I get more information through this blog its very useful to me thank you
    Diabetes foot, Diabetes diet, Diabetes ulcer, symptoms of Diabetes, Diabetes treatment, Diabetes sore, Diabetes ulcer

    March 12, 2014 at 07:01 | Report abuse | Reply
  37. abpdermal

    The diabetes is a hidden killer disease it very dangerous and your blog is awesome. you clear my doubts about diabetes and its used more people keep post more blog than you.
    Diabetes foot, diabetes ulcers

    March 18, 2014 at 05:41 | Report abuse | Reply
  38. abpdermal

    The wound and sore ulcer is affected usually because of people carelessness but if the saw your blog means they have taken extra care of them health. Thank you for posting blog keep more posting blog because it very useful to people

    June 25, 2014 at 05:31 | Report abuse | Reply
  39. iqbal

    Very Nice and Informative Post Diabetic Foot Infection

    October 20, 2014 at 13:43 | Report abuse | Reply

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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.