DIABETIC SKIN CARE by Darlene McCord

Educational Objectives:

At the conclusion of the talk (paper), the audience member (reader) will be able to:

1. Discuss the extent and seriousness of diabetes mellitus in the United States,

2. Understand the pathogenesis of diabetic neuropathy,

3. Relate the serious complications of diabetes mellitus,

4. Understand the 500 Dalton Rule and

5. Identify some of the ingredients in Olivamine® patent pending and what beneficial effects they have on the skin.

Background:

Epidemiology

Diabetes mellitus is characterized by high blood glucose (hyperglycemia) which can be due to: a) decreased production of insulin (called Type I diabetes mellitus) due to destruction of the pancreas on an autoimmune basis or b) decreased peripheral sensitivity to insulin (called type II which also has some decreased production of insulin by the pancreas) associated with obesity and lack of physical activity. Only about 5-10% of the total have type I disease, the rest have type II.

The most recent statistics available (2005) reveal 20.8 million people (7% of the population) with diabetes of which 14.6 million were actually diagnosed leaving 6.2 million unaware of the presence of this serious disease. Moreover, its prevalence has increased 40% in the last decade and is expected to increase by 165% between 2000 and 2005 (figure 1). It has been estimated that fully 1/3 of the population born in 2000 will develop diabetes. In addition to patient suffering and disability, the economic impact in direct and indirect costs is enormous, amounting to $132 billion in 2002 representing 1/10th of all health care costs.

There were 224,092 deaths attributable to diabetes in the USA in 2002 (probably an underestimation). The risk for death in patients with diabetes is twice that for people of the same age without diabetes, and this decreased longevity is due to cardiovascular disease. Diabetes increases the risk of heart disease and stroke 2-4 fold over that for people without diabetes. Its microvascular complications of retinopathy, nephropathy, and neuropathy make diabetes mellitus the leading cause of blindness, end-stage renal disease, and non-traumatic lower extremity amputations in the U.S.A.2 The frequency of the last complication is increasing (figure 2).

Centers for Disease Control and Prevention. National diabetes fact sheet: general information and national estimates on diabetes in the United States, 2005. Atlanta, GA: Department of Health and Human Services, Centers for Disease Control and Prevention, 2005.

National Diabetes Fact Sheet, United States, 2005. Data from the Lewin Group, Inc. for the American Diabetes Association.

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