Evaluating microcirculation in diabetics early on can help to develop a treatment plan that can help avoid complications like amputations. In the case of patient Rose D, early intervention helped save her great toe from amputation. Rose was a 63-year-old woman with a history of obesity, hypertension, high cholesterol, and severe diabetes with uncontrolled blood sugar levels. After suffering from an ingrown toenail, she later developed a large, deep, and bleeding ulcer on the tip of her left great toe. Analysis at a vascular surgery clinic clearly showed she was suffering from microcirculation malfunction due to her uncontrolled diabetes. Rose participated in a treatment regimen, consisting of strict blood sugar control and treatment with the transdermal vasodilator D’OXYVA, which effectively healed her ulcer and prevented amputation of her left great toe.
What is Diabetes?
Diabetes is a condition in which the pancreas is not able to produce the hormone insulin, which controls blood sugar levels, leading to abnormally high blood sugar levels. Elevated blood sugars can then cause damage to the large and small blood vessels supplying the eyes, feet, kidneys, heart, and nervous system, leading to end organ damage and organ failure.
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Symptoms of Diabetic Complications in the Feet
Symptoms of diabetes mellitus-related foot complications include the following:
- Changes in the skin color of the feet
- Ankle or foot swelling
- Numbness of the feet or toes
- Leg pain
- Open sore on the feet
- Slow healing of wounds or ulcers
- Ingrown toenails
- Fungal infections of the toenails
- Corns or calluses that bleed
- Dryness and cracking of the heel
Avoiding Diabetic Foot Ulcers
The risk of developing diabetic foot ulcers can be reduced by
- Wearing appropriate shoes
- Checking feet for cracks, redness, or ulcers daily
- Carefully controlling and checking blood sugars
- Reducing risk factors like smoking and drinking alcohol
- Monitoring cholesterol levels
- Reducing friction and abnormal pressure on the feet
- Taking all possible measures to increase blood flow D’OXYVA
How Does Diabetes Affect Microcirculation?
Microcirculation refers to the very small blood vessels that branch off from larger blood vessels throughout the body to deliver oxygen and remove CO2 from the organs of the body. In diabetes, the chronically high blood sugar levels cause damage to the microcirculation1 through sclerosis (scarring) of the small blood vessel walls. This causes damage to both organs involved and the nerves supplying them. When the nerves are damaged in areas like the foot, there is a loss of what is known as protective sensation and a resultant failure to respond to normal pressures and irritations, thus leading to ulcers.
Risk of Amputations in Diabetes
Recent studies by the American Podiatric Medical Association2 indicate that approximately 15% of patients with diabetes will eventually develop ulcers of the feet, with 14% to 24% of those patients ending up with amputations. Each year, over 100,000 lower limbs are amputated, with most resulting from diabetic complications. After one amputation, the risk of needing another amputation in 3 to 5 years increases to about 50%.
Methods to Evaluate the Microcirculation in Diabetes
Method 1 – Transcutaneous Oxygen Tension
Transcutaneous Oxygen Tension (TOT) 3 refers to a noninvasive method to assess blood flow in the microcirculation. TOT works by measuring the amount of oxygen molecules transferred to the microcirculation of the skin after heating it to 40 degrees Celsius.
Method 2 – Skin Pulp Blood Flow
Skin pulp blood flow refers to the amount of blood flow in the pulp areas of the toes. This can be evaluated either by laser doppler fluxmetry, which measures the flow of red blood cells, or by comparing blood flows after administering a vasodilator (vasoreactivity).
Patients with severely reduced blood flow due to microcirculation damage from type 2 diabetes mellitus are at increased risk of developing complications such as painful foot ulcers. This is due to reduced blood flow and nerve damage, which prevent avoidance of undue friction and rubbing. Evaluating microcirculation dysfunction due to diabetes early in the course of the disease and treatment with modalities like D’OXYVA can help avoid complications like amputations.
HOW D’OXYVA CAN HELP?
Clinical studies with D’OXYVA® (deoxyhemoglobin vasodilator) have shown* extraordinary results for the role of transdermal non-invasive wound care using ultra-purified, non-toxic FDA-cleared molecules, such as CO2, especially when all other approaches failed.
In an ongoing multi-year, multi-country, multi-center, randomized clinical trial on patients with diabetic foot ulcers, D’OXYVA has demonstrated speeding up diabetic wound healing and ultimately wound closure to an average of 5 weeks**.