Detroit Receiving Hospital, Mich.

Currently, about 4 percent of the population has diabetes and the percentage will be progressively increasing as we get an older and older population.

Of these diabetics, approximately 15-20 percent will develop ulcers on their feet. A lot of this is because of poor circulation that they have. In spite of good pulses, the small vessels have poor circulation, and on top of that, they have neuropathy; that is, the nerves to the feet do not interpret correctly when there is pain or pressure. As a consequence, they are much more likely to injure their feet. And once they injure their feet they are less likely to heal.

Unless a diabetic gets adequate therapy early for these diabetic ulcers on their feet, within five years, they will probably lose one or both extremities. And once they lose one extremity, there's about an 80 percent chance they will lose another extremity. And once they have bilateral amputations, 80 percent of them will probably be dead within the next five years.

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Many of these patients, if they are diagnosed early and if they don't respond to early therapy, which usually includes at least 30 days of antibiotics, debridement, and other preventative measures, they should get hyperbaric oxygen. In most instances, hyperbaric oxygen along with a good program of treatment, along with antibiotics and debridement, can heal these within one or two months. This automatically greatly increases not only the ability of the patient to move around, but also their life expectancy, and it greatly reduces the cost of medical care.

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