A recent study published by doctors at the University of California revealed that amputations resulting from diabetes in poor income areas can be prevented. In the study, doctors determined that low-income patients in certain California communities are at increased risk for amputations resulting from diabetes. Few studies have reviewed geographic patterns to determine a link between medical outcomes and income levels, but doctors looked at 7,939 cases in 6,828 people who had amputations as a result of diabetes-related complications. They found that in certain areas of California where the average income is lower, people were as much as 10 times more likely to lose a toe or a leg to the disease.
There are basically two different kinds of diabetes. Type 1 diabetes occurs when the body does not produce insulin, a hormone which controls the level of glucose. Glucose is needed to produce energy for cell production and growth. In Type 2 diabetes, the body produces insulin but it is not able to use it properly. The majority of people diagnosed with diabetes are classified as Type 2. Millions of people in the U.S. have Type 2 diabetes, but because it can sometimes be present with no symptoms, approximately one third of those who have Type 2 diabetes do not know that they have the disease.
Risk factors for diabetes include being overweight and being physically inactive. Family history plays a part, as does race. Experts do not currently understand why, but African Americans, Hispanics and Asian Americans are at increased risk for developing diabetes. Age, blood pressure and unhealthy cholesterol levels can also be contributing factors.
When it is not diagnosed or left untreated, diabetes can have a significant impact on health. Unchecked, diabetes can lead to problems with the heart, kidney disease, loss of sight and even death. Uncontrolled diabetes can also weaken the immune system causing nerve damage that can prevent a person from detecting small breaks in the skin. These cuts can then lead to serious cases of infection. The infection, in turn, can lead to amputation but doctors maintain that these types of amputations, even in poor income areas where the incidence of diabetes may be extremely high, are largely preventable.
There is good news for people diagnosed with Type 2 diabetes. The disease can be controlled by maintaining a healthy weight, being physically active and eating a healthy diet centered around fruits and vegetables. Education to help people understand the disease and its symptoms, as well as access to testing, would go a long way toward getting diabetics the preventive care necessary to manage the disease and eliminate more catastrophic outcomes.
In poorer neighborhoods, there is often limited access to medical care, due to lack of transportation and the cost of care. Removing these obstacles could in fact increase the number of cases diagnosed and treated. Dr. Carl Stevens, who headed the study at the David Geffen School of Medicine at UCLA, is hopeful that studies like this one will increase knowledge and spur lawmakers into passing laws that broaden access to care in poor income areas and ultimately prevent unnecessary amputations caused by diabetes.
By Constance Spruill
National Institutes of Health (2)
Type 1 Diabetes