Generally these are recommendations to protect us from diabetic foot ulcer :
shoe inserts to prevent corns and calluses
We could also remove diabetic foot ulcers with a debridement, the removal of dead skin, foreign objects, or infections that may have caused the ulcer in the worst case. The most successful method along with the above is a Stem Cell Treatment
Stem cells treatments an emerging treatment tool
*Stem cell treatment for diabetic foot ulcer is gaining raising importance in today’s world as it provides a high rate of recovery and the use of adult mesenchymal stem cells is gaining importance given in a huge breakthrough supported by clinical trial.
* The present study on” Induced Wound Healing by Application of Expanded Bone Marrow Stem Cells in Diabetic Patients With Critical Limb Ischemia “that has got recent importance .
“Diabetic foot (DF) is a concomitant illness of diabetes mellitus. Diabetes is one of the main causes of non-traumatic amputation worldwide due to severe peripheral arterial occlusive disease with chronic critical limb ischemia being the most abundant problem. Ulceration occurs as failure of oxygenation, nutrient supply and progressive occlusion of larger blood vessels often exacerbates pre-existing microvascular abnormalities.
WHAT IS DIABETES?
The word, “diabetes” comes from the Greek verb “diabeinein” meaning “to stride or stand with legs asunder.” Hence, “diabetes” means “one that straddles” or more specifically, “siphon.” This term was therefore applied to the disease of diabetes due to the characteristic excessive discharge of urine.
Diabetes actually includes any of several metabolic disorders marked by an excessive discharge of urine and persistent thirst, including diabetes mellitus.
Diabetes mellitus is a disease in which a person has elevated blood sugar, either because pancreatic cells, called Islets of Langerhans, does do not produce enough insulin, or because insulin-receptor cells in the body do not respond to the insulin that is produced. Insulin is needed to transport sugar (glucose) into cells where it is metabolized into energy.
SIGNS AND SYMPTOMS
The classical symptoms of diabetes are polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger).Symptoms may develop rapidly (weeks or months) in type 1 diabetes while in type 2 diabetes they usually develop much more slowly and may be subtle or absent.
Prolonged high blood glucose causes glucose absorption, which leads to changes in the shape of the lenses of the eyes, resulting in vision changes; sustained sensible glucose control usually returns the lens to its original shape. Blurred vision is a common complaint leading to a diabetes diagnosis; type 1 should always be suspected in cases of rapid vision change, whereas with type 2 change is generally more gradual, but should still be suspected.
People (usually with type 1 diabetes) may also present with diabetic ketoacidosis, a state of metabolic dysregulation characterized by the smell of acetone, a rapid, deep breathing known as Kussmaul breathing, nausea, vomiting and abdominal pain along with and an altered states of consciousness.A number of skin rashes can occur in diabetes that are collectively known as diabetic dermadromes.
Acute complications include hypoglycemia, diabetic ketoacidosis, or nonketotic hyperosmolar coma. Serious partially reversible long-term complications include, cardiovascular disease, chronic renal failure, and retinal damage.
Type-I diabetes (formerly referred to as juvenile diabetes or insulin-dependent diabetes) is a chronic condition in which the Islets of Langerhans in the pancreas produce little or no insulin. Various factors may lead to the development of type-1 diabetes, including genetics and exposure to certain viruses. While all the causes of type-I diabetes are not understood, it is known that the body’s immune system might accidentally attack and destroy the islet cells of the pancreas when endeavoring to attack harmful bacteria or viruses. It is important to note that although type-I diabetes typically appears during adolescence, it can, in fact, develop at any age. Because there is little or no insulin to transport sugar into cells where the sugar can then be converted to energy, type-I diabetes can cause life-threatening complications.
Type-II diabetes (once known as adult-onset or non insulin-dependent diabetes) is a chronic condition that can arise from either insufficient insulin secretion or from the body becoming resistant to the effects of insulin. In type-II diabetes, the islet cells are not destroyed, but they produce less insulin, or other cells in the body are resistant to the insulin that is produced. Whichever the case, in type-II diabetes,
Both type-I and type-II diabetes are chronic conditions that are believed to be permanent and progressive. Although I thought early onset type-II could be reversed if caught early.
Diabetes mellitus is characterized by recurrent or persistent elevated blood sugar, and is diagnosed by demonstrating any one of the following abnormal results:
A fasting plasma glucose level ≥ 7.0 mmol/L (126 mg/dL) repeated on different days or a Plasma glucose ≥ 11.1 mmol/L (200 mg/dL) two hours after a 75 g oral glucose load. This was known as the glucose tolerance test and has been shown to be inaccurate and generally is not used. Additionally an elevated Glycated hemoglobin (Hb A1C) ≥ 6.5%. or symptoms of hyperglycemia with a casual plasma glucose of ≥ 11.1 mmol/L (200 mg/dL).
A positive result, in the absence of unequivocal hyperglycemia, should be confirmed by a repeat of any of the above-listed methods on a different day. It is preferable to measure a fasting glucose level because of the ease of measurement and the considerable time commitment of formal glucose tolerance testing, which takes two hours to complete and offers no prognostic advantage over the fasting test. According to the current definition, two fasting glucose measurements above126 mg/dL (7.0 mmol/L) is considered diagnostic for diabetes mellitus.
People with fasting glucose levels from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) are considered to have impaired fasting glucose. New work in the field has now suggested that the current levels of “acceptable” blood glucose are no longer appropriate. The subtle changes of even having a mild case of impaired blood sugar results in the formation of adverse AGE’s.
The insidious precursor to type-II diabetes—prediabetes—affects 35% of adults age 20 and older, and half of Americans age 65 and older. Prediabetes is a condition in which a person’s blood-sugar levels are higher than normal, but not high enough to be diagnosed as diabetes. Symptoms usually do not present acutely enough that people seek a doctor’s advice or a blood test; the symptoms are typically borderline and easily dismissed.
In the early stages of type-II diabetes, medications can be administered that improve insulin sensitivity or reduce glucose production by the liver.
Alternatives to medications or insulin injections for treating diabetes have included pancreatic transplants resulting in limited success in in type-I diabetes mellitus and gastric bypass surgery resulting in varied success rates in those with type-II diabetes mellitus stemming from morbid obesity.
The Stem Cell Process
After a review of your medical records, a protocol is designed specifically for you. We will determine the best source of stem cells for your current condition. The cells can be found in your bone marrow or adipose (fat), or we will also consider the use of cord blood-derived stem cells.
Initially, you will be examined and evaluated upon arrival. The examination will include laboratory samples to determine the need for stem cell stimulation, prior to harvesting.
Remember that this disease has many lifestyle causes that can and should be addressed. We will provide counseling to reduce the progression and maximize the effects of stem cell therapy. Before administering your stem cell therapy, we will ask you to fill in a grading form to accurately determine your current symptoms, and then after your stem cell therapy we will ask you to fill out periodic follow-up forms to accurately determine your degree of improvement. You will be enrolled, at no cost to you, in a two year follow-up program, with ICMS, the International Cellular Medicine Society, an independent registry agency. The post treatment evaluation forms, will be set to you periodically to assess your improvement, on a 1-3 month basis.
After a review of your medical records and discussions with medical staff, a protocol is designed especially for you. Specifics of your condition are addressed along with any special needs. It may be similar to the one illustrated below:
At the clinic you will be examined by our physicians. Information including any risks and expectations concerning your treatment, plus answers to any questions you may have will be addressed. A blood draw, to determine cell counts and other chemistries will be collected and cell expansion medication may be administered. Then you will return to your hotel for a restful day or a good nights sleep.
Our physician/s will review the laboratory results, determine if the cell count is within range, and discuss the response to the stimulation. They may or may not provide additional cell expansion medications and may add adjunctive treatments. The levels of your response will determine if you would return to the hotel, with little restriction on your activities, or possibly go forward with harvesting and processing your cells.
If the cell count and viability is appropriate for harvest either a bone marrow or adipose collection will be utilized. We typically use local anesthetics for adults and general anesthesia for youngsters. The entire procedure normally takes less than 30 minutes. Although some pain is felt when the needle is inserted, most patients do not find the bone marrow collection procedure particularly painful or uncomfortable.
We recently placed a number of videos on our website interviewing our patient’s who discuss the procedure and their lack of discomfort.
After the collection you may return to the hotel, with some restrictions. The bone marrow or adipose collected is processed in our contract State-Of-Art laboratory by trained staff, under the supervision of the lab physician.
As an alternative to the above, cord blood may be used based on the patient’s individual medical condition and options.
At the clinic you will be treated by IV infusion . You will be required to restrict your activities and potentially spend the day at the hotel, after the treatment.
The patient will receive a post-treatment examination and evaluation prior to their release. Additional therapy and treatments may also be utilized to maximize the placement and activities of the procedure.You may either return home or optionally there may be the use of additional ancillary therapies to enhance the procedure.
WHAT MAKES OUR TREATMENT DIFFERENT
Our approach includes stimulation, prior to collection, processing and expansion of the cell along with the use of growth factors, together with an integrated medical approach. This maximizes the growth and implantation potentials yielding optimized potentials of making changes in your disease.
Our staff physicians are all board certified, in their field with years of experience. Your team includes both primary and ancillary care professionals devoted to maximizing your benefits from the procedures. We enroll you in an open registry to track your changes independently, for up to 20 years.
As our patient we also keep you abreast of the newest developments in stem cell research. This is an ongoing relationship to maintain and enhance your health.
Our promise is to provide you with travel and lodging support, access to bilingual staff members throughout the entire process and most importantly the best medical care possible.