Written by Dr. Jose Andres Gonzalez
Diabetes mellitus (DM) is a high prevalence disease in Rio Grande Valley area. It is associated with lack of normal utilization of glucose, main source of energy or the human being.
It is in most cases a hereditary; it is progressive without good care deterioration is the pattern.
Multiple systems are affected with the disease, the more important are vascular, neurologic, and immune system. All this is related to the lack of good oxygen supply, the only oxygen carrier is blood which is supply by the vascular system, which is deeply affected in patients with diabetes mellitus.
Neuropathy is one of the more common complications of this disease, it is also related to the lack of good oxygen supply of the nerves, affecting the sensation, motor activity and prone patient for deformities that eventually will develop ulcers that can end up in amputations.
Immune system is also affected, making the patient more susceptible to infections that will advance more rapidly than non-diabetic patients. Patient already have poor quality tissue due to the lack of oxygen, it can turn into severe sepsis, even death.
Vascular system is important in order to provide oxygen to the tissues through the blood, unfortunately is the most affect in diabetes mellitus. Arthrosclerosis will be more prevalent in DM patient than non-DM patients, it will be more severe, creating a serious problem that can affect patient life quality as well of their family. All this together will create a great ground for complications that are usually seen in these patients
Patients need to be aware how important and serious is this disease and the possible complications, in order to minimize, prevent them and maximize their life quality.
Amputation unfortunately is more common seen on these patients, however now these days there are multiple options of treatments in order to prevent or minimize it.
Vascular surgery is the specialist that can offer more treatment options going from minimal invasive (endovascular) to very complex procedures (bypass or combination of endovascular procedures); in order to preserve the extremities and improve life quality in this patients. It is important to remember that DM is surgical condition, however they have complex medical issues that need the collaboration of other specialist, to obtain a good outcomes.
Good care and medical management after interventions is crucial; among this is an attention to minimal details, such as special footwear, regular and adequate wound care. Glucose control ( hemoglobin A-1 C as close as possible to 6.5) , regular checkups with primary care doctor , vascular surgeon and another specialist involved on a care of a specific need to each patient.
Resuming good prevention in DM it is the more important factor to prevent and minimize complications of this disease (very common in this area). Choosing the right specialist, vascular surgeon, able to manage and provide treatment option, tougher with good coordinated medical team to treat this complex disease is crucial to obtain good outcomes.
