Foluso A. Fakorede, MD, received his medical degree from UMDNJ-Robert Wood Johnson Medical School in Camden, NJ. He completed his internship and residency at New York Presbyterian Weill Cornell Hospital and returned to New Jersey for a fellowship in cardiology, interventional cardiology, and endovascular intervention at Cooper University Hospital in Camden. Today, he is an expert at preventive cardiovascular management, women’s heart health, and catheter-based procedural focus in coronary atherosclerosis disease (CAD) and peripheral atherosclerosis disease. He has advanced technical skills in preventing amputations, and in 2015 he opened Cardiovascular Solutions of Central Mississippi in Cleveland, located in the Mississippi Delta. Dr Fakorede is a national advocate for ending health disparities in underserved communities.
Atherosclerosis and peripheral artery disease are significant long-term complications of diabetes that demand more education and quality care to prevent limb loss. The conclusion of National Diabetes Month offers an opportunity to draw attention to ways to prevent these outcomes and screen for them early.
With the holiday season fast approaching, most Americans are looking forward to feasting with family and friends and taking a much-needed break from work.
However, for over 30 million Americans living with diabetes and 84.1 million living with prediabetes, the consumption of unhealthy food and long periods of inactivity during the holiday season can make symptoms worse. Diabetes is a public health crisis, costing $327 billion dollars per year, according to the most recent analysis from the American Diabetes Association. As many as 1 in 3 U.S. adults could have diabetes by 2050 if current trends continue, according to a new analysis from the CDC. Racial and ethnic minorities have a higher prevalence and greater burden compared with whites. Disparities in health and health care lead to higher rates of complications in minority populations.
November is National Diabetes Month and is the perfect time to promote awareness of diabetes and diabetes-related complications so that, through awareness, we can prevent the suffering diabetes causes to ourselves, our families and our friends. It is important for everyone to be aware of this disease and its complications.
One important complication of diabetes is the development of atherosclerosis and peripheral arterial disease (PAD). Atherosclerosis is the hardening of our arteries and accumulation of fatty deposits in our arteries. Our arteries are delicate tubes that carry blood with oxygen and nutrients to all the parts of our bodies. There is no room for plaque! Plaque narrows these vessels and restricts blood flowing through them. If the narrowing is severe, the blood flow can become completely blocked causing a lack of blood to an affected body area, for example, the brain, the heart, the leg. If there is a lack of blood flow to any of these areas, the results can be devastating, especially if we do not recognize the symptoms in time to get help. A lack of blood flow to the heart can cause the death of heart muscle. If the brain is affected, a stroke can occur. If the legs are affected, this can lead to pain in the legs, poor healing of diabetic ulcers, gangrene, and eventual amputation.
When atherosclerosis affects the limbs, this is called peripheral arterial disease, or PAD. We know that PAD the one complication of diabetes that causes the most significant long-term disability and economic burden. It is estimated that 1 out of 3 people with diabetes 50 years of age or older has PAD, yet millions of people with diabetes don’t realize they are at risk for losing a limb until it is too late. Each year, approximately 200,000 non-traumatic amputations occur. African Americans are 4 times more likely to experience diabetes-related amputation than whites. In the United States, every 17 seconds someone is diagnosed with diabetes, and everyday 230 Americans with diabetes will suffer an amputation. Throughout the world, it is estimated that every 30 seconds a leg is amputated. And 85% of these amputations were the result of a diabetic foot ulcer.
Unfortunately, as the epidemics of diabetes and PAD worsen, people still don't recognize the symptoms. Early detection and treatment of the PAD is crucial to saving limbs. With timely screening, in-depth assessment of symptoms and thorough physical examinations, millions of amputations could be prevented. Like cancer, PAD must be caught early and treated to prevent progression and suffering. It is often asymptomatic in the early stages, making ultrasound screenings a life-saving necessity.
As a limb salvage specialist, I am committed to educating and providing quality healthcare to prevent the loss of limbs. Early screening, diagnosis and intervention saves legs and thus preserves quality of life. More importantly, it saves lives, as 50% of diabetics who experience amputation will die within 2 years of the amputation.
To help prevent complications from diabetes and PAD, it is important for everyone to manage this disease every day. A little physical activity goes a long way in soothing leg pain and keeping blood flowing to the legs and feet. Controlling blood sugars, knowing your glycated hemoglobin (A1C) number, and eating a well-balanced diabetic diet can significantly reduce the risks for PAD and amputations. By quitting smoking, individuals can reduce 6-fold their risks for PAD!
On a national scale, I recently joined a group of advocates in Washington, DC, to call on lawmakers to adopt a national strategy to increase public awareness of PAD. This distinguished group of advocates included both physicians and patients who have endured amputations, who had a shared mission to change policy to help prevent unnecessary limb loss. PAD advocates are asking the Trump administration to convene an intragovernmental workgroup to develop a standardized model for amputation reduction and to raise awareness on this critical issue.
Whether you feel pain in your legs or not, every diabetic should talk to their doctor about screening for PAD. Take your shoes off at every appointment with your doctor and learn how to exam your feet. Take control of your health this November during National Diabetes Month. Doing so can literally save your limbs and your life.
Foluso Fakorede, MD, is a practicing cardiologist and CEO of Cardiovascular Solutions of Central Mississippi as well as co-chair of the PAD Initiative for the Association of Black Cardiologists.