The Case for Diabetic Awareness

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Matthew Regulski, D.P.M., of the Wound Care Institute of Ocean County, addresses the need for early detection, diagnosis and treatment of diabetes.

Matthew Regulski, D.P.M. (pictured) of the Wound Care Institute of Ocean County addresses the need for early detection, diagnosis and treatment of diabetes.

“We need to better educate everyone on diabetes and the need to detect, diagnose and treat this disease,” Regulski said.

“Diabetes is an insidious and devastating disease,” according to Matthew Regulski, D.P.M., the Director of the Wound Care Institute of Ocean County. “Its diagnosis is on the rise throughout the world in epidemic proportions. That’s why we need to educate the general public, especially our youth, about the dangers of diabetes and the importance of early detection, diagnosis and treatment.”

Diabetes is associated with the result of Lower Extremity Amputation (LEA), which is preceded by the development of a foot ulcer. In fact, 90 percent of those with diabetes who undergo an LEA also have a history of foot ulcers, according to Dr. Sharad Pendsey, a senior diabetologist based in Nagpur.

In the United States, more than 73,000 LEAs occur each year. They occur 10 times more frequently in those with diabetes than those without the condition, according to Bharara Mills and Suresh Armstrong (Int Wound J, 2009) and Wound Repair and Regen (2016; 24:705-711). The primary reason for diabetics to be admitted to the hospital is an infected diabetic foot ulcer. Worldwide, every 30 minutes, a leg is lost to a landmine, but every 30 seconds a leg is amputated because of diabetes, according to Bharara Mills and Suresh Armstrong (Int Wound J, 2009).

In addition to pain and reduced quality of life, three of five patients with a diabetic LEA will die within five years of the first amputation. About 34 percent of those with an LEA will have a second, more extensive amputation within 16 weeks of the initial amputation, indicating that diabetic amputees may have a persistent inability to heal, according to Wound Repair and Regen (2016; 24:705-711).

The cost of treating LEA and its complications is equally staggering. Annually, Diabetic Foot Ulcers (DFUs) cost nearly $40 billion. In 2012, treating diabetes and related complications reached $245 billion, with direct costs of $176 billion and indirect costs (disability, work loss and premature death) of $69 billion. These numbers are expected to grow rapidly as the number of diabetics diagnosed increases. Of 30 million diabetics now in the United States, 8.1 million people do not know they have it and 80-90 million more people are pre-diabetic, according to the CDC Division of Diabetes Translation, National Diabetes Surveillance System.

“Obesity is the underlying mechanism for the development and propagation of Type II diabetes because of the chronic inflammation that it engenders,” Regulski said. “It leads to the initiation and the progression of Type II diabetes and its devastating complications.” One out of every three children in the US is deemed obese, which will lead to a frightening rise in newly diagnosed young diabetics, according to the American Heart Association.

For people between the ages of 20 and 79, the mortality rate from diabetes and related complications is nearly 20 percent, but this number may be even higher since the death rate from diabetes is vastly underreported as the primary cause of death, Regulski added. Studies have shown that just 35-40 percent of death certificates list diabetes as the primary cause when, in reality, diabetes is the primary cause of death in well over 70 percent of these cases, according to the CDC Division of Diabetes Translation, National Diabetes Surveillance System.

“This is why we need to better educate everyone on diabetes and the need to detect, diagnose and treat this disease,” Regulski continued. “It knows no boundaries. It does not discriminate, does not care if you are black, white or brown. It doesn’t distinguish man, woman or child, rich or poor, where you live or how you live.”

Regulski underlines the need for more diabetes outreach and advocacy. “Little changes can make a big difference,” he continued. “For example, professional athletes and their respective associations could start waving the green flag of diabetes during sporting events.”

People need to associate the diagnosis of diabetes with the need to seek immediate treatment. “When people learn they are diagnosed with cancer, there is a sense of urgency to seek treatment without delay,” Regulski said. “But when the diagnosis is diabetes, there is no comparable sense of urgency, since signs of the disease are delayed. Many think taking a pill or having an injection will control and cure it. That is an often fatal mistake.”

Diabetes is the primary cause of blindness, kidney failure and non-traumatic lower extremity amputation throughout the world, according to Regulski. “If we don’t comprehend the seriousness and the urgency about diabetes and its complications not only to patients, but also to the public with a particular emphasis on adolescents, then we should start building more hospitals, making more prostheses and developing more cemeteries.”

For more information about the Wound Care Institute of Ocean County or its several locations or services, visit woundcareinstituteofoceancounty.com or call 732-736-5509.

About Matthew Regulski, D.P.M.
Matthew Regulski, D.P.M. is Director of the Wound Care Institute of Ocean County, NJ; a partner of Ocean County Foot and Ankle Surgical Associates, and a member of the American Podiatric Medical Association.

About the Wound Care Institute of Ocean County
The Wound Care Institute of Ocean County is the leader in wound care management, and is dedicated to the diagnosis and successful treatment of chronic and debilitating wounds. The Wound Care Institute follows the highest levels of evidence-based medicine and offers various treatment algorithms using the most advanced cellular therapies, as well as vascular services and surgical reconstruction. The Wound Care Institute of Ocean County is also involved in multiple clinical trials that have tremendous impact on the way wound healing is performed. To learn more, visit http://www.woundcareinstituteofoceancounty.com.

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Laura Crossan
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