Canadian Diabetes
Published quarterly, Canadian Diabetes provides practical, current information to family physicians on diagnosis and treatment issues associated with diabetes.
Assessment and Management of the Diabetic Foot
Currently, 2.3 million Canadians are living with diabetes, of whom approximately 345 000 will develop a foot ulcer (1). A significant minority of diabetic foot ulcers fail to heal and will require limb amputation; in 2006, >4000 Canadians with diabetes had a limb amputated (1). Limb amputation is associated with a significant risk of mortality: 30% of Canadians with limb amputation will die within 1 year of amputation and 69% will not survive beyond 5 years (1).
CD--Dec_2010--Editorial.pdfhttp://www.diabetes.ca/documents/for-professionals/CD--Dec_2010--Editorial.pdf">Read full article.
Sarah E. Capes MD MSc FRCPC, Diana Sherifali RN PhD CDE
Évaluation et prise en charge du pied diabétique
Au Canada, il y a actuellement 2,3 millions de personnes diabétiques et environ 345 000 d’entre elles présenteront un ulcère du pied1. Une importante minorité d’ulcères du pied diabétique ne se cicatrisent pas et entraînent une amputation. En 2006, une amputation a été nécessaire chez plus de 4000 personnes diabétiques au Canada1. L’amputation est associée à un important risque de décès. En effet, 30 % des Canadiennes et des Canadiens ayant subi une amputation meurent dans l’année suivante et 69 % d’entre eux ne vivent pas plus de cinq ans après une amputation1.
Sarah E. Capes, MD, MSc, FRCPC, et Diana Sherifali, IA, PhD, EAD
Évaluation et prise en charge du pied diabétique
Au Canada, il y a actuellement 2,3 millions de personnes diabétiques et environ 345 000 d’entre elles présenteront un ulcère du pied1. Une importante minorité d’ulcères du pied diabétique ne se cicatrisent pas et entraînent une amputation. En 2006, une amputation a été nécessaire chez plus de 4000 personnes diabétiques au Canada1. L’amputation est associée à un important risque de décès. En effet, 30 % des Canadiennes et des Canadiens ayant subi une amputation meurent dans l’année suivante et 69 % d’entre eux ne vivent pas plus de cinq ans après une amputation1.
Sarah E. Capes, MD, MSc, FRCPC, et Diana Sherifali, IA, PhD, EAD
Peripheral Arterial Disease in People with Diabetes: Risk Factors, Assessment and Management
The prevalence of diabetes is increasing and the population is aging. These factors alone increase the risk of peripheral arterial disease (PAD) in the community. The sequela of PAD is increased mortality; thus, it is crucial that PAD be diagnosed early and intervention initiated, thereby increasing the possibility of prolonging life and preventing lower-extremity amputations (LEAs). As outcomes can be severe, it is important to assess patients with PAD adequately, and implement strategies to aggressively address risk factors and improve arterial flow, if possible. If improving arterial supply is not feasible, appropriate care must be taken to prevent infection.
Rajna Ogrin BSc BPod(Hons) PhD, Ann-Marie McLaren DCh BSc MClSc
Optimizing Pharmacologic Management of Diabetic Neuropathic Pain
Pain management has not been well taught in medical curricula. A 2007 Canadian survey showed that veterinary students were taught 5 times more about pain than medical students (1). Both diabetes and chronic pain are common conditions. Twenty percent of the general population suffer from some type of chronic pain (2) and 25% of people with diabetes have neuropathy, a heterogeneous disorder affecting both proximal and distal peripheral sensory and motor nerves that is caused by nerve damage due to toxic metabolites produced by hyperglycemia (3). The following case studies illustrate various aspects of neuropathic pain management in people with diabetes. A recent Canadian guideline for pharmacologic management of neuropathic pain is summarized in Table 1 (4).
Ellen N. Thompson MB BS FRCPC
Canadian Diabetes Winter 2010 - Full Issue
Production of materials has been made possible through a financial contribution from the Public Health Agency of Canada.
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