Peripheral Neuropathy Numb Feet and Hands Symptoms Resolved TheVillagesNeuropathy
When you had originally presented to the office,you presented with chronic numbness, tingling, burning,the hands and the feet. It limitedyour ability to walk, limited your ability to sleep, your ability to relax. We've completeda course of treatment here with the Davis neuropathy program, how have you done withthe treatment and how are you feeling today? I feel wonderful. I have to tell you thatthe treatment, I was on both programs. Before I came in, all that I knew that I had wasperipheral neuropathy after your exam, after you examined me. We found out that I had alsospinal stenosismy spine. I have followed your program, both of your programs, the DRSprogram and the peripheral neuropathy program,
and I am doing beautifully. I can now walkwithout assistance which I was having to hold my husband's hand or somebody's hand whenI was shopping or doing anything. I could not ive by myself. I feel like a whole personnow. Well congratulations on your results and we're very proud to have you here as apatient. What else would you like to have me tell you? If you have another questionI could certainly, I would like to tell a little bit about your people that you haveworking for you. They are wonderful, young, professional people. I don't know what kindof a program you put them on, but I love each and every one of them. They're an asset toyour office. Well thank you so much for the
kind words and we look forward to seeing youagain soon. You're welcome.
T2DM Diabetic Retinopathy Chronic Kidney Disease
Hello, I'm Norman Swan. Welcome to this programour serieson guidelines and type 2 diabetes. Every year there areabout 3.8 million deaths globally attributable to diabetes. In Australia, type 2 diabetes isthe fastestgrowing chronic disease, with the total number of Australianswith diabetes and prediabetes estimated at a whopping 3.2 million, and it's the sixthleadingcause of death.
This program looks at two NHMRCevidencebased guidelines that are new and adess compliionsand comorbiditytype 2 diabetes. They are the evidencebased guidelinesfor diagnosis and management of kidney diseasetype 2 diabetes, and the guidelines for the managementof diabetic retinopathy. For those of youwatching on your computers, you can type your questions directly into the studio. Just click on the LiveTalk tab at thetop of the web page you're looking at.
That also means, of course,that we can ask questions of you. Here's one to get you going: away on that one, and we'llgive you results of thata moment. As usual, there are a numberof useful resources available on the Rural Health EduionFoundation's website: Now let me introduce our panel to you. Stephen Twigg is an endocrinologistat the University of Sydney and Presidentof the Australian Diabetes Society.
Welcome, Stephen. Good evening. Alan Cass is the senior director of the George Institutefor International Health, and director of the PocheIndigenous Health Centre at the University of Sydney. Welcome, Alan. Good evening, Norman. Paul Mitchell isProfessor of Ophthalmology at the University of Sydney,and runs the Blue Mountains Eye Study.
Welcome, Paul. Thanks, Norman. Good to be here. And David Guest is a rural generalpractitionerGoonellabahNSW. Welcome. Thanks, Norman. David, challenging, dealing with comorbiditiesin general practice, I assume. It's a growing area. It's a bigger and bigger problem. It's something that's takingmore and more of GPs' time.
If you get systemsplace, you canprobably cope with the challenge. Talk to me about the trendsthat are going on, Stephen. As you've mentioned already,diabetes is on the rise. We believe that approximately100,000 people per yearAustralia are developing diabetes. It's very similarto the worldwide trend. There are a number of factors thatare probably criticalthe processterms of the development of diabetes.
Lucentis effective for proliferative diabetic retinopathy
The National Eye Institute is very pleasedtoday to announce new al trial results that will benefitpeople at risk of vision loss from diabetic retinopathy.The trial demonstrates that injections of the ug Lucentis are effectivetreating proliferative diabetic retinopathy, or PDR.I think this study will have a major impact on the treatment of PDR. I think you will over time see a number of physicians go away from the standard of treatment, which up until now has been the laser, and use the
Lucentis treatment for these patients. What is proliferative diabetic retinopathy, or PDR? Diabetic retinopathy is a very important disease that affects the back of the eye the tissue that is known as the retina. The retina is a verycomplied tissue and requires a great deal of blood supply.With diabetes the blood supply sometimes goes awry and you don't have enough nutrition to the retina. So the retina makesblood vessels That's known as proliferative diabetic retinopathy. And they
can cause bleeding and ultimately retinaldetachment. All Patients who have diabetes are at risk todevelop proliferative disease. What is laser or panretinal photocoagulation? Around the late 1960s and early 1970s, laser wasinvented as a tool for patients who had eye disease. Panretinal photocoagulation, where we basically destroy the peripheralretina was effective In stopping blindness from proliferative diabetic retinopathy. So, it's been a revolutionary treatment inpreserving vision,
but it comes at a cost. And that cost hasbeen one that we've had to deal with for the last 50 years. It'sthe destruction of the peripheral retina, which causes decreased side vision and decreased night vision. What is Lucentis, or Ranibizumab? Lucentis is an antibody, which when injected into the eye, bonds to VEGF. Andproliferative diabetic retinopathyyou have an excess production of this protein, of the VEGF, thatstimulates the growth of blood vessels that should not begrowingthe back
of the eye. It became apparent that we couldclose the abnormal blood vessels that led to blindness withouthaving to destroy the peripheral retina.What are Lucentis injectionslike? This is probably the most common procedure that we do forany retinal disease today. The first injection is always.youknow, you're very nervous but um Elman was very efficient,very good, they numb your eye very well. And he says lookover there and then he's Says well I'm done. What were the results? Whatthe study showed
was that the Lucentis injections were at leastas good as laser Andsome ways it was better. And uh itwas well tolerated. In patients who are going to be getting the injectionsanyhow because they have swelling or edemathe centerof vision it's an obvious choice to give them the injections and notto do laser. What is the DRCR Network?The DRCR Networkstands for Diabetic Retinopathy al Research Network. Itbrings together scientific investigatorsthe academic settingand private