March 4, 2002
Complications
Question from Grand Rapids, Michigan, USA:
My 76 year old mother, who has had type 2 diabetes for about five years (and suspects she had it for five5 years prior to the diagnosis), is very good at keeping blood sugar records, and the doctors have complemented her over the years on keeping good numbers and doing the right things. However, since last Fall, her feet have been causing her a lot of pain, which appears to be worsening.
At her doctor’s visit last week, she was told that her feet were blue and cold and that she had no pulse in her feet. This really threw her since previous reports were always upbeat. Now she is very worried about the possibility of amputation. The doctor set up an appointment with a vascular surgeon for some tests in about two weeks. What will the vascular surgeon do? What is the likely outcome in a case like this? She is a smart, tough lady and can deal with facts. Can you give me some to pass on?
Answer:
It sounds like the attending physician is concerned about obstructive vascular disease. This means that a clot, somewhere in the arterial system, is blocking blood flow into the foot. The obstruction may be high or low [near the groin, or near the foot].
The vascular surgeons may be able to by-pass an obstruction if high enough in a large artery. With diabetes, sometimes the occlusion is in a small artery which does not lend itself to by-pass surgery. You will have to wait and see what the evaluation shows to know more about potential therapies. I am afraid I cannot be more specific at this time.
JTL
