Marvin Isley, bassist from the R & B family, the Isley Brothers has died at age 56. From 1975 to 1980, the Isley Brothers had 14 Top 10 R&B records, including “Fight the Power Part 1,” “Harvest for the World,” and “Livin’ in the Life.” Isley had been diagnosed with diabetes over 20 years earlier and had stopped performing in 1996 after suffering complications from diabetes that included a stroke, high blood pressure, the loss of both legs and use of his left hand. He died at a hospice facility in his home town of Chicago.
People with diabetes can, over time, develop nerve damage throughout the body. Some people with nerve damage have no symptoms. Others may have symptoms such as pain, tingling, or numbness—loss of feeling—in the hands, arms, feet, and legs. Nerve problems can occur in every organ system, including the digestive tract, heart, and sex organs.
About 60 to 70 percent of people with diabetes have some form of neuropathy. People with diabetes can develop nerve problems at any time, but risk rises with age and longer duration of diabetes. The highest rates of neuropathy are among people who have had diabetes for at least 25 years. Diabetic neuropathies also appear to be more common in people who have problems controlling their blood glucose, also called blood sugar, as well as those with high levels of blood fat and blood pressure and those who are overweight.
The causes are probably different for different types of diabetic neuropathy. Researchers are studying how prolonged exposure to high blood glucose causes nerve damage. Nerve damage is likely due to a combination of factors:
Symptoms of peripheral neuropathy may include
These symptoms are often worse at night.
Peripheral neuropathy may also cause muscle weakness and loss of reflexes, especially at the ankle, leading to changes in the way a person walks. Foot deformities, such as hammertoes and the collapse of the midfoot, may occur. Blisters and sores may appear on numb areas of the foot because pressure or injury goes unnoticed. If foot injuries are not treated promptly, the infection may spread to the bone, and the foot may then have to be amputated.
More than half of all lower-limb amputations in the United States occur in people with diabetes—86,000 amputations per year. Doctors estimate that nearly half of the amputations caused by neuropathy and poor circulation could have been prevented by careful foot care.
People with diabetic neuropathy need to take special care of their feet. The nerves to the feet are the longest in the body and are the ones most often affected by neuropathy. Loss of sensation in the feet means that sores or injuries may not be noticed and may become ulcerated or infected. Circulation problems also increase the risk of foot ulcers.
Joslin Diabetes Center, in Boston, Massachusetts, is one of the world’s foremost institution for diabetes research, clinical care and education. According to Joslin-Beth Israel Deaconess Foot Center’s Dr. Richard A. Jackson:
“One in four people with diabetes will develop foot complications. That means that making foot care a part of your daily diabetes regimen is essential for avoiding serious complications such as neuropathy, vascular disease, and injury. When it comes to implementing a comprehensive foot care plan, a little effort goes a long way in preventing problems.
Inspect. Check your feet two times a day, ideally in the morning and at night before you go to bed. Look for anything out of the ordinary, such as areas of redness, blisters, or cuts. If you discover a wound, treat it and cover it with a bandage immediately. Pay close attention to the wound during subsequent foot inspections to be certain it is healing properly.
Protect. Washing your feet every day with mild soap in tepid (not hot) water is your first line of defense against problems with your feet. After washing, dry your feet thoroughly and apply a lotion made for people with diabetes, or one that your doctor has approved. Moisturizing your feet will protect against the creation of fissures in the skin, which can serve as a breeding ground for infection.
Prevent. Elevated blood glucose (blood sugars) puts people with diabetes at risk for neuropathy, or nerve damage, which can cause loss of sensation in the feet, leading to other serious complications. Good control will help you prevent these complications. You can also reduce or even prevent the risk of injury to your feet by selecting comfortable footwear.
Consult. If you are very physically active or if you have other foot problems, it is important to find a doctor to examine your feet on a regular basis to avoid any complications that may arise. All other patients with diabetes must have a foot exam at least once a year.”
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