Diabetes Complications and Foot Amputation " Fred is a 66-year-old man who was diagnosed with type 2 diabetes "

Case study ( 974 views as of May 25, 2017 )

Fred is a 66-year-old man who was diagnosed with type 2 diabetes when he was in his 30's, due to a history of alcoholism. Fred managed to live for some time with little changes to his health, other than regular insulin injections. About 10 years ago, Fred went into kidney failure and needed regular dialysis before finally receiving a kidney transplant 5 years ago. Fred has recovered well from the transplant and his kidney is monitored regularly.

Unfortunately, Fred began having circulation problems in his feet over the past 2 years, and has been struggling to get the sores on his feet under control. His physician is beginning to talk about the possibility of amputation to all of his toes to control the issue and prevent the spread of his circulation issues.

Fred would benefit from a referral to an orthopaedic surgeon to review the necessity of amputation. He could also speak with his endocrinologist about the current state of his diabetes management, and his pharmacist to review his medication list for any possible interactions. Fred could consult with a dietitian who is a Certified Diabetes Educator about his nutrition intake, and an athletic therapist to review safe exercises to promote his circulation. Finally, Fred will likely need some kind of prosthetic or custom footwear to maintain his mobility following his amputation surgery.

Author:
1

Conversation based on: Diabetes Complications and Foot Amputation " Fred is a 66-year-old man who was diagnosed with type 2 diabetes "

Diabetes Complications and Foot Amputation " Fred is a 66-year-old man who was diagnosed with type 2 diabetes "

  • Controlling his diabetes through diet would be an key strategy for Fred. Often people associate diabetes with the need to limit the amount of carbohydrates eaten, but with type 2 it's more about the type and how consistent the intake is. Consistency of carbohydrate intake is important so insulin release is steady, instead of spiked. Eating complex carbs (which take longer to digest and absorb) in place of simple carbs will help control insulin spikes. The case doesn't specify, but because of the advanced stage of his condition I would think he has developed insulin resistance - meaning his body can't effectively utilize his blood sugar. A dietitian working with a diabetes program would be a great step!
    Flag as inappropriate