Diabetic Osteopathy Case Study

Diabetes can be treated in three basic ways: by diet, by diet in conjunction with tablets, or diet in conjunction with insulin. Diet serves as an initial control for non-urgent patients. If a person’s diet will have a major effect on glycaemic control, it does so reasonably quickly, within a few weeks of changing

Diabetes is a disease where the body is unable to produce or use insulin effectively. Insulin is needed for proper storage and use of carbohydrates. Without it, blood sugar levels can become too high or too low, resulting in a diabetic emergency. It affects about 7.8% of the population. The incidence of diabetes is known to increase with age. It’s the leading cause of end-stage renal disease in the US, and is the primary cause of blindness and foot and leg amputation. It is known to cause neuropathy in up to 70% of diabetic patients. Individuals with diabetes are twice as likely to develop cardiovascular disease. There are two types of diabetes: Type 1 and Type 2.

They include: heart and blood vessels, eyes, kidneys, nerves, gums and teeth. In regards to the heart and blood vessels, there are approximately 65% of death that is caused by diabetes due to major complication of heart disease and stroke. In the peripheral artery diseases diabetes also plays a major role in the cause of poor blood flow in the legs and feet. Many studies show that controlling diabetes can prevent or stop the progression of heart and blood vessel disease. Blood vessel damage or nerve damage may also lead to foot problems that can lead to amputations. More than 60% of leg and foot amputations not related to an injury are due to diabetes. Another complication of diabetes is the leading cause of blindness in the U.S. There has been a number of eye problems that if not addressed can lead to eye blindness which include: glaucoma,cataracts and diabetic retinopathy. Ninety percent of diabetic-related blindness as study shown could be prevented if there would be regular eye exams and timely treatment of diabetes-related eye problems. Furthermore, kidney failure is also one leading cause of further complication that resulted from uncontrolled diabetes in the U.S. It is said that drugs that help lower blood pressure can help the chance to developing kidney failure by 33%. Also diabetes on nerves can lead to loss of sensation or pain and burning of the feet because nerves are harmed due to over time high blood sugar levels. It can also

Those who are diabetic may also be in risk of blindness (diabetic retinopathy) and nerve damage (diabetic neuropathy). Diabetic neuropathy can lead to numbness in hands and feet, foot ulcers, and eventual limb amputation (World Health Organization). Taking preventive steps can help to avoid many of the complications of diabetes.

Most patients who have diabetes for an extended amount of time may end up with diabetic neuropathy, which is damage caused to the nerves; it affects the peripheral nerves, autonomic nerves, and focal nerves. From the high blood sugar, it can destroy parts of the patient’s blood vessels, heart, and kidneys. If diabetes is not treated, it will almost always cause heart disease or kidney disease.

Diabetic neuropathy can occur with long-term diabetes, usually after several years of uncontrolled high blood glucose. Glucose proteins, called glycoproteins, form in the nerves primarily those in the legs and feet. When the nerves in the feet are damaged, the brain cannot recognize pain in that area. Nerve damage from diabetic neuropathy can lead to weakness in the muscles in the legs and feet. Since the muscles work as a system, neuropathy can lead to other foot problems, such as hammertoes, calluses, bunions, and other foot deformities. These deformities are dangerous because of the risk of infection. A simple blister from a tight shoe can spell disaster

It is estimated that 387 million people, globally live with diabetes (Phillips & Mehl, 2015). According to Medical News Today [MNT], diabetes is a metabolic disorder; which causes patients to be extremely thirsty and produce a lot of urine. Diabetes arises due to high blood pressure, due to the body not being able to produce enough insulin or because the body does not respond well to high insulin levels (MNT, 2016). There are four types of diabetes; there is the pre-diabetic stage, type 1 diabetes, type 2 diabetes and gestational diabetes. In 2014, 29 million people died due to diabetes. This equates to 1 diabetic patient dying every seven seconds due to preventable complications (including complications affecting lower limbs) caused by diabetes. It is said that 20-40% of health care costs are spent on the treatment of lower limb complications due to diabetes. The risk of a diabetic patient developing a foot ulcer is 25% and foot ulcers account approximately 85% of lower limb amputations. Diabetic complications that affect lower limbs are caused by both type 1 and type 2 diabetes (Phillips & Mehl, 2015). It is said that the World Health Organization described diabetic foot syndrome as including all possible complications in relation to the feet of a diabetic patient. Diabetic foot syndrome is defined as the ulceration of the foot, from the ankle downwards. Causes of foot ulceration include peripheral sensory neuropathy, vascular disease (ischaemia) and infection

People who have cancer, shingles, and diabetes are more susceptible to be Diabetic Neuropathy victims. They often experience the effects of this condition in their legs and feet, so it is very important for people with this condition to take care of their feet. Some of the symptoms are numbness, tingling, pain, and burning. Nerve pain varies in everyone with this condition. Some people may feel like they are walking on hot coals or sleeping with stabbing pains while other people may just not be able to feel their fingertips and it is like they are wearing gloves. People who have more severe cases often have trouble sleeping because they feel excruciating pain from the weight of their bodies on the bed and pain and burning just from the pressure from a blanket. Creams, sprays, and medications can help decrease the symptoms of Diabetic Neuropathy, but in the end, it just comes down to living a healthy

Vascular diseases that prevent blood flow to the small vessels are common in people with diabetes. This condition can affect the feet in particular, so you should make regular visits to a podiatrist. People with diabetes also have a reduced ability to heal even minor blisters and cuts. A podiatrist can monitor your feet for any serious infections that could lead to gangrene and amputation.

Diabetic Peripheral Neuropathy (DPN) is one of the most common microvascular complications in diabetes and can result in foot ulceration, ampuation and an impaired quality of life(Carrington AL, et al 2002,Boulton AJ,et al 2004). The reported prevalence of diabetic peripheral neuropathy ranges from 16% to as high as 66%2 and its prevelance is believed to increase with the duration of diabetes and poor glucose control.(Boulton AJ.et al 2000) It’s accounts for 50–75% of non-traumatic amputations in diabetic patients.(Holzer SE, et al 1998, Boulton AJM, 1998,Malay DS, et al 2006)

One of the most common long-term complications of diabetes mellitus is painful neuropathy. Diabetic neuropathy is estimated to affect about 60-70% of all diabetes patients and can lead to foot ulcers, amputations, and decreased quality of life. The most common form is chronic peripheral neuropathy which results in pain and numbness in the extremities, usually described as a burning, tingling, or steady aching pain.1 Patients may also feel increased sensitivity to pain or experience paresthesia, a sensation of tingling, tickling, or prickling of the skin.1 According to current guidelines, intensive glycemic control is very important for the prevention and reduction of peripheral neuropathy and other microvascular complications.1,2 Medications used to help relieve nerve pain include duloxetine and pregabalin (Lyrica®), which are both approved by the U.S. Food and Drug Administration for use in diabetic neuropathy. Other drug classes commonly used are antidepressants, anticonvulsants, and opioids.3 Although there are many medications used for this condition, pain relief is often insufficient for patients. Treatment is difficult due to the complicated pathophysiology of pain transmission and the wide range of mechanisms of action of drugs used to treat pain. Therefore, there is a continued need for additional medication options for this chronic painful condition. Lacosamide is an anticonvulsant approved for use as monotherapy or adjunctive therapy for partial-onset seizures.

Diabetes is associated with wide range of complications such as chronic renal failure, blindness, amputations, heart disease, high blood pressure, stroke, and neuropathy (Alotabi, A., et al., 2016). There is no known cure for diabetes, but the disease can be controlled through health management that includes multiple perspectives of care such as medications, blood glucose monitoring, diet, nutrition, screening for long-term complications and regular physical activity (Alotabi, A., et al., 2016). Managing diabetes may be complicated and requires the knowledge and skills of both healthcare providers and the clients. Studies have shown that to prevent or delay diabetic complications due to diabetes, counseling and other lifestyle interventions are the effective therapy. Even with many policies set up for diabetes, 8.1 million Americans are undiagnosed with diabetes mellitus, and approximately 86 million Americans ages 20 and older have blood glucose levels that considerably increase their risk of developing Diabetes Mellitus in the next several years (CDC, 2015). For diabetes care to be successful there needs to be a good understanding of the disease and management by both patients and healthcare providers,

Diabetic neuropathy is nerve damage that occurs with diabetes. Approximately half of all people with diabetes have some form of neuropathy. It is more common in people who have had the disease for many years. Tight control of blood sugar can prevent neuropathy from occurring. Those who already have diabetic neuropathy can stop it and prevent it from becoming worse with healthier eating habits, medications and exercise.

Eligible patients are at ≥ 18 years to ≤ 75 years who diagnosis of painful diabetic peripheral neuropathy in both lower extremities. Patients who suffer from lower extremity pain for at least 6 months and had been given a primary diagnosis of PDPN. Patient eligibility required a score of ≥4cm on VAS at screening and a score of ≥3 on MNSI.

An estimated 16 million Americans are known to have diabetes and a substantial amount more are at risk for developing this disease. In Americans, approximately 3-6% of the population has diabetes (AADE, 2014). As you age, Type 2 diabetes begins to rise affecting how your body metabolizes glucose. With Type 2 diabetes, glucose continues to build and lead to high blood sugar causing a variety of symptoms contributing to the development of a diabetic foot ulcer. According to the American Podiatric Medical Association,