Diabetic Foot-1 - DiabeticFoot N.CraigStone April17,2003...

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    Diabetic Foot  N. Craig Stone  April 17, 2003
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Introduction Epidemiology Pathophysiology Classification  Treatment
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Epidemiology DM largest cause of neuropathy in N.A. 1 million DM patients in Canada Half don’t know Foot ulcerations is most common cause of  hospital admissions for Diabetics Expensive to treat, may lead to amputation and  need for chronic institutionalized care
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Epidemiology $34,700/year (home care and social services) in  amputee After amputation 30% lose other limb in 3 years After amputation 2/3 rds  die in five years Type II can be worse 15% of diabetic will develop a foot ulcer
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Pathophysiology ?Vascular disease? Neuropathy Sensory Motor  autonomic
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Vascular Disease 30 times more prevalent in diabetics Diabetics get arthrosclerosis obliterans or  “lead pipe arteries” Calcification of the media Often increased blood flow with lack of  elastic properties of the arterioles Not considered to be a primary cause of  foot ulcers
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Neuropathy Changes in the vasonervorum with  resulting ischemia ? cause Increased sorbitol in feeding vessels block  flow and causes nerve ischemia Intraneural acculmulation of advanced  products of glycosylation  Abnormalities of all three neurologic  systems contribute to ulceration
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Autonomic Neuropathy Regulates sweating and perfusion to the  limb Loss of autonomic control inhibits 
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Diabetic Foot-1 - DiabeticFoot N.CraigStone April17,2003...

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