Proper care for diabetics can prevent amputation

The best way to treat diabetic foot sores is by wearing proper shoes and by visiting foot clinics.

By JUDY SIEGEL-ITZKOVICH
insulin injection (photo credit: )
insulin injection
(photo credit: )
Every year some 900 Israeli diabetics undergo amputation of a foot due to preventible complications, according to the Israel Diabetes Association (IDA), which will mark World Diabetes Day on Monday. Reduced blood flow to the limbs, caused by poorly controlled blood sugar, can lead to foot sores that fail to heal and subsequently to amputation, says the IDA. Regular monitoring and treatment, however, can save these patients from severe disability. Although most leg amputations occur in Type II diabetics over the age of 65, younger patients are affected, as well - 70 percent of all leg amputations performed on Israelis over 35 are on diabetics. The best way to treat diabetic foot sores is prevention, which can be accomplished by wearing proper shoes and regular visits to a foot clinic. Those who fail to do so and suffer sores can be helped with a variety of treatments ranging from medications to skin transplants, blood vessel dilators and bypass surgery, and treatment with ozone or hyperbaric (high-pressure) oxygen. Type II diabetes is a lifestyle disease usually caused by being overweight and lack of physical activity, which causes insulin resistance and minimizes the number of effective insulin-producing beta cells in the pancreas. The vast majority of diabetics have the Type II form. The minority have Type I, which is commonly, but mistakenly, called "juvenile diabetes." Type I is an autoimmune disease with a genetic basis that usually, but not always, first appears in children or teenagers; their immune system destroys their beta cells, making them dependent on insulin injections to balance their blood sugar levels. The Israel Juvenile Diabetes Association will hold an event Friday, before World Diabetes Day, between 3 and 8 p.m. at Tel Aviv's Exhibition Grounds (building 10) to mark the organization's 25th anniversary. The association, founded by parents of children with Type I diabetes, aims at increasing awareness of the disease and helping to find a cure. "Insulin is not a cure. It is just a way to live to reach the time of the next [daily] injection. For us, a cure is the main thing," the association's leaders say. The Tel Aviv event will include lectures by diabetes specialists on new technologies; news about beta cell transplants; and discussions about how parents can cope with diabetes in their children. Meanwhile, the chairman of the Israel National Council on Diabetes, Prof. Itamar Raz, denounced the publication by Yediot Aharonot on Wednesday of a story by Natasha Mozgovia claiming that "every second Israeli child... born after 2000 will contract juvenile diabetes by the age of 30." The writer was "totally confused" by a press release issued by the Israeli branch of the Juvenile Diabetes Research Foundation, chaired by Shulamit Nuss, he said. Raz, who heads the diabetes unit at Jerusalem's Hadassah University Medical Center and is a former president of the IDA, said it was unfortunate if the news story alarmed parents unnecessarily. "Type I diabetes is relatively rare, affecting only 0.1% of the population. In recent years, there has been only a very small case in the prevalence of the disease, and there is no indication that there will be an epidemic in the future." Just 5% to 10% of diabetes cases are Type I, with the rest being Type II, he said. "Only if a child has an identical twin who had Type I diabetes and who himself is obese and not physically active will his risk of Type I diabetes reach 50%," Raz declared. Until recently, Type II diabetes was reserved for middle-aged adults. Yet, because of increased obesity and lack of physical activity in children, Type II has been diagnosed in young adults, teenagers and even some children. About 8% of the Israeli population has Type II diabetes and, if the current trend continues, it will rise to 20% in two or three decades. Raz said action must be taken to prevent a diabetes Type II epidemic by changing diets and lifestyles but that the situation was far from the frightening headlines in Yediot Aharonot.