Diabetes and DPN

Okay, at some point I'll stop blogging about these medical webinars . . . but not tonight! I actually found the latest one that I attended fairly fascinating. Seriously.

At the church where Jonathan used to be pastor, we joked among ourselves that there must be "something in the water": Out of a congregation of about 60 people, there were two who were missing limbs. One was a man who'd lost his arm in a farming accident (and he was an amazing woodworker, especially considering his injury!) and a "senior saint" who'd lost her leg due to complications of Diabetes. About a month after we left, we heard that she had realized one of her worst fears: She'd lost her other leg.

I have to admit that I had no idea exactly why the amputation of limbs has anything to do with Diabetes, which is pretty pathetic, considering the fact that it runs in my family, and my dad has had it for a few years, now.

In a nutshell, the following is what I learned about diabetic peripheral neuropathy, or DPN (they also called it "Silence of the Limbs"--bahaha!).

• Peripheral nuropathy--relating to the limbs--is the most common complication of Diabetes, occurring in 50-90% of patients (depending o the criteria used for diagnosis)
• Up to 70% of diabetics will lose sensation in their feet.
• Approximately 25% develop foot ulcers, which often become infected, requiring hospitalization, with a 20% chance of amputation.
• Of those who have major amputations, almost half will have the other limb amputated within 3 years, and a startling 50% of them will die within 5 years of having their first limb amputated.

Okay, suddenly the idea of tingling, numbness, or burning foot pain seemed pretty serious. I had no clue! Basically, the sensory loss and atrophy of nerve fibers is the problem, and it leads to infections simply because the patient can't feel pain from cuts or burns or whatever.

(As a side note, one huge way to decrease amputation rates is for Diabetes patients to undergo regular foot examinations at home as well as during doctor visits. I learned that the latter often takes insistence on the part of patients, which is so, so sad! In the mean time, the primary treatment option for Diabetes slows the disease's progression, the secondary option is simply pain management. Often toleration of side effects or maxing out the efficacy of pain meds leads to issues as attempts are made to mask pain, while the disease continues progressing.)

The good news is that peripheral nerve fibers have the ability to repair and regenerate with adequate blood flow. The bad news is that blood flow is often lessened in patients who have DPN. But there's more good news (or so it seems): Nutritional support in the form of a newly available medical food can aid in Nitric Oxide Synthesis, improving blood flow. Treatment over 6 months has seen to result in 97% increase in nerve fiber density, potentially decreasing amputation rates by 50%! (This "medical food" is considered "gras," or "generally recommended as safe," with risk factors similar to taking a placebo--i.e., not very high at all!)

Until there's a medical discipline that takes ownership for DPN, patients will need to be proactive in examining their feet, asking about various treatments, and insisting that their doctors examine their feet at regular visits.