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Nerve Disorder Can Lead to Amputation.

Diabetes has a variety of physical symptoms and complications. Diabetic neuropathy is a resulting nerve disorder that can influence many areas of the body. It is associated with other devastating consequences, including blindness, heart disease, kidney failure, and limb amputation. Neuropathy is most likely to affect people who have had diabetes for a long time or whose glucose (blood sugar) control is poor, though it has not been proven how high glucose levels must get before nerve damage occurs. This complication is progressive, getting worse over time and as blood sugar levels fluctuate or remain high.

Doctors are still not certain why diabetic neuropathy occurs. "A possible theory may be that, when the glucose level in the blood is high for a length of time, the buildup of glucose or its metabolites in the actual cells is also high. These high sugar levels and their metabolites may become toxic to the nerves over time," indicates Kenneth S. Hershon, director of research at North Shore Diabetes and Endocrine Associates, New Hyde Park, N.Y., and medical advisor to the Don't Sugar-coat the Facts Diabetes Education Campaign, sponsored by Silipos, a New York-based manufacturer of foot care products for diabetics.

The first sign of diabetic neuropathy may include numbness or pain in hands, feet, or legs (peripheral neuropathy). Prolonged nerve damage also triggers problems with the internal organs, such as the digestive tract, heart, and sexual organs, causing indigestion, diarrhea or constipation, dizziness, bladder infections, and impotence (autonomic neuropathy).

When neuropathy is present in the legs and feet, the possibility of a foot injury going unnoticed increases, which can lead to amputation from an ulcerated wound. This is because the person does not feel the injuries and may not be able to see them on the sole of the foot. The problem is compounded if the person with diabetes has poor circulation that slows the healing process. This means that the risk is greater for a sore or blister to get infected and ulcerated, which can ultimately lead to the loss of the limb. According to the American Diabetes Association, 62% of nonhealing ulcerations lead to almost 46% of all amputations.

"What many people may not realize is that most diabetic-related amputations are actually preventable," notes Hershon. "It is very important that the diabetic be proactive rather than reactive with this disease, especially with wounds." Most of the complications that arise from having neuropathy in the feet and legs can be avoided, he points out, if the diabetic takes the initiative to maintain good health, which includes regular physical examinations, self-examinations of the feet, proprer fitting shoes, good podiatric care, and lifestyle changes.
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Publication:USA Today (Magazine)
Article Type:Brief Article
Date:Feb 1, 2001
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