November 17, 2019
Diabetes and Amputation: Why It’s Done and How to Prevent It

Diabetes and Amputation: Why It’s Done and How to Prevent It

>>Dr Jonathan Valabhji: Here at Imperial we’ve
had a focus on diabetes on diagnosis and treatment and care for people with both type
1 and type 2 diabetes for a number of decades. Diabetes over many years can damaged nerves
so the people develop numbness in their feet they can no longer feel their feet so imagine
if you’re walking down the street and you get a stone in your shoe it hurts and so
you do something about it. If you don’t feel that stone in your shoe you carry on walking
until the stone potentially makes a hole in your foot. The fact is that people can in
the worst-case scenarios lose a limb, lose a leg>>Linda Bloomfield: So this is their primary
lesion that we’ve been treating Mr. Mcready for since September. It’s certainly a lot
small and less deep than it has been and it has been and it currently shows no sign of
infection. As podiatrists what we have to do is keep on top of the callus formation,
that span the lesion if we allow that develop and it can cause and further breakdown beneath
it. That’s why we often see Mr Mcready twice a week if not certainly once a week;
for wound dressing and just to make sure things haven’t deteriorated. As specialist podiatrists we are very much involved
in the treatment and assessment of diabetic foot complications. With ulceration we are
particularly concerned about the development of infection which can be a precursor to
an amputation which is what we’re very much trying to avoid. We will be reviewing him with our
modern disciplinary team in a few weeks’ time which includes our vascular surgeons,
just to review if there is anything further we can and should be doing to promote faster
healing. An open wound can always become infected so we do need to be doing our utmost
make sure are healing healing as quickly as possible.>>Ken Mcready: I just wasn’t aware enough
of the dangers of where having a high blood sugar level the damage it could be doing.
Because I have severe neuropathy, certainly in the amputation of the other toe the other
toe I didn’t feel it; I never had moments pain or discomfort however this is the big
toe and the effect on that maybe a little bit more severe on me I don’t know. Literally lose weight and check what you’re eating you know people are not aware of how
to analyse what food they’re eating because you have a loaf of bread this got natural sugars
but it’s going to add sugar already in it.>>Dr Jonathan Valabhji: We want to reduce
the risk of people developing type 2 diabetes and that’s what the NHS that that’s what
the healthier You: NHS Diabetes Prevention Programme aims to do. People who have been identified
to be in the high-risk category can now be referred into programmes generally speaking
it’s a nine-month intervention it involves at least 13 face-to-face meetings with a health
coach or health trainer who will use behavioural change techniques to inform people about
the importance of and how to make changes in real-life settings around diet so that
they can lose weight increase the physical activity and improve the nutritional quality of their
food intake.

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