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Related Concept Videos

Diabetic Foot Ulcer01:31

Diabetic Foot Ulcer

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Definition A diabetic foot ulcer (DFU) is a chronic, non-healing wound that develops in individuals with diabetes. It typically occurs on pressure-bearing areas such as the heel, metatarsal heads, or hallux, and carries a high risk of infection and amputation.Pathophysiology • The development of DFUs can be explained by four interconnected mechanisms: neuropathy, ischemia, infection, and impaired wound healing. • Neuropathy is the most common factor. Sensory...
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Complications of Diabetes Mellitus01:22

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Diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia due to insulin deficiency, resistance, or both. Prolonged hyperglycemia disrupts metabolic homeostasis and leads to acute and chronic complications.Acute ComplicationsAcute complications result from sudden metabolic imbalance.Diabetic ketoacidosis (DKA) mainly appears in type 1 diabetes but may also develop in type 2 diabetes, particularly under extreme stress. It arises from severe insulin deficiency,...
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Diabetic Retinopathy01:27

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DefinitionDiabetic retinopathy is a microvascular complication of diabetes affecting the retinal blood vessels.Risk FactorsDiabetic retinopathy is present in almost all individuals with type 1 diabetes and more than 60% of those with type 2 diabetes after two decades of disease.The risk increases with poor glycemic control, hypertension, dyslipidemia, smoking, pregnancy, and puberty.Although cataracts and glaucoma are also more frequent in people with diabetes, retinopathy remains the leading...
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Diabetes: Symptoms, Diagnosis, and Complications01:15

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For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
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Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
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Type I Diabetes II: Pathophysiology01:26

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Type 1 diabetes mellitus arises from an immune-mediated destruction of pancreatic β-cells, resulting in an absolute deficiency of insulin. This process develops in genetically susceptible individuals when autoimmunity, environmental exposures, and immunologic dysregulation converge to trigger a targeted attack on the insulin-producing cells of the pancreas. The β-cells are located within the islets of Langerhans and are essential for regulating blood glucose by facilitating cellular...
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Distance as a risk factor for amputation in patients with diabetes: a case-control study.

D Gallagher, V Jordan, P Gillespie

    Irish Medical Journal
    |May 20, 2014
    PubMed
    Summary

    Patients living further from diabetes centers face higher amputation risks, especially those with neuropathy. This highlights the need for accessible diabetes care to prevent lower limb amputations.

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    Area of Science:

    • Endocrinology and Metabolism
    • Vascular Surgery
    • Public Health

    Background:

    • Diabetes mellitus is a leading cause of lower limb amputations worldwide.
    • Geographic accessibility to specialized diabetes care centers may influence patient outcomes.
    • Understanding factors associated with amputation risk is crucial for preventative strategies.

    Purpose of the Study:

    • To investigate the association between residential distance from diabetes care centers and lower limb amputation risk.
    • To identify key predictors of amputation in diabetic patients, considering geographic and clinical factors.

    Main Methods:

    • A case-control study was conducted, matching 66 amputation cases with 313 controls (no amputation) by age and sex.
    • Comparison of residence distance to diabetes centers, diabetes duration, type, HbA1c levels, and foot examination findings.
    • Multivariate analysis was used to determine significant predictors of amputation.

    Main Results:

    • Amputation cases resided significantly farther (12.1 km greater) from diabetes care centers compared to controls (p = 0.028).
    • Diabetes duration (OR/year 1.07) and neuropathy (OR 10.73) were the strongest independent predictors of amputation.
    • Patients with neuropathy lived substantially farther (97 km) from centers than those without (p = 0.01).

    Conclusions:

    • Increased distance to diabetes care centers is associated with a higher risk of lower limb amputation.
    • Neuropathy and longer diabetes duration are critical risk factors, potentially exacerbated by geographic barriers to care.
    • Improving access to diabetes care may reduce amputation rates, particularly for patients with neuropathy.