Nerve disease caused by type-2 Diabetes accounts for half of all amputations in the U.S., but a new treatment is helping patients keep their limbs.  And it comes from a pregnant woman!

Diabetic sores on Rocco LoBosco’s left foot robbed him of his little toe and doctors told him could lead to worse.

“There’s still a chance that you might lose part of the foot, or the whole foot, or even the leg," LoBosco told Ivanhoe.

But by harnessing the power of amniotic fluid, Dr. Richard Jacoby, Medical Director at the Scottsdale Neuropathy Institute in Scottsdale, Arizona, says it’s possible to avoid that.

“Amniotic fluid seems to meet the criteria to develop new tissue," Dr. Jacoby explained.

Amniotic fluid from a pregnant donor is injected into or wrapped around the nerve during decompression surgery. The stem cells in the fluid stimulate the affected area, telling it to heal the wound.

“I’ve done 16 nerves with this technique and all of them have restored their sensation," Dr. Jacoby said.

The new technique not only helps save limbs, but lives as well.

“Your life expectancy is 2 years after an amputation," Dr. Jacoby explained.

LoBosco had the surgery, and a month later, there is a noticeable difference.

“I had no feeling whatsoever in either of my feet," LoBosco said. "Now, I feel [my feet]…I couldn’t do this before.”

There are about 100,00 amputations each year in the U.S. Dr Jacoby says he also just used the treatment to help a woman with multiple sclerosis get out a wheel chair and start walking with a cane. The amniotic fluid comes from donors from an FDA approved laboratory.

 

BACKGROUND:  People with diabetes are more likely to have a foot, toe, or leg amputated than other people.  It happens because diabetics have blood vessel disease, which reduces blood flow to the feet, and nerve disease, that reduces sensation in the feet.  These two conditions together cause sores and infections that may lead to amputation.  Despite changes in care over the years, foot, toe, and leg amputations are still common.  Research has been able to show links between risk factors like high blood pressure and high blood glucose and a person’s chance of having a lower-extremity amputation (LEA).  However, more research needs to be done in order to evaluate which patients with diabetes are most at risk.  (Source: www.diabetes.org)

 

TYPE 1 DIABETES:  The Wisconsin Epidemiologic Study of Diabetic Retinopathy was a long-term study of eye disease in people with type 1 diabetes that was conducted to find out how common lower-extremity amputations were in people with type 1 diabetes.  It involved 943 patients.  Researchers looked at how many patients got diabetes-related lower-extremity amputations over the years.  They also looked at other possible risk factors like sex, age, age at diabetes diagnosis, length of time with the disease, blood glucose and blood pressure control, smoking status, weight, and the presence of other diabetes-related complications. Over the course of 25 years, about ten percent of the patients had an LEA. People with type 1 diabetes have a high chance of needing an LEA over the long term. Those with high blood glucose or high blood pressure and those who are heavy smokers are at a greater risk. (Source: www.diabetes.org)

 

NEW TECHNOLOGY:  Building upon past research, Dr. Bruce Werber of InMotion Foot & Ankle Specialists developed a treatment for diabetic foot ulcers that prevents amputations.  Dr. Werber gets the open, infected wounds to close by injecting them with amniotic fluid.  "We now have amniotic membrane and fluid that is cryopreserved. So it can be used on anybody at anytime and anywhere and morselized so it can be injected. We don't have to have a live birth to collect it, and it can be harvested in very clean, sterile conditions. We inject it in and around the wound, and it enhances the healing,” Dr. Werber was quoted as saying.  (Source: http://www.samuelmerritt.edu)  Dr. Werber says a diabetic ulcer happens when diabetics lose sensation in their feet.  It’s called neuropathy, and it happens gradually.  He says diabetics may get a cut and don’t know it.  That cut could then become infected and the wound can erode through the skin and down to the bone.  He says even a small diabetic ulcer can become life-threatening.  In his study of 20 patients, they all had wounds that were unresponsive to other more traditional treatments.  He said they injected the amniotic membrane around the wounds, and they started to close within days.  The membrane has mesenchymal stem cells, which have all of the nutritional materials the tissue needs to heal.  It stimulates the body very aggressively to start to create healthy tissue.  Dr. Werber says of the 20 patients, all of their wounds have responded, and 90 percent have closed in the last year.  “Everybody had progression, which is pretty remarkable for any medication,” Dr. Werber said.  (Source: http://www.azcentral.com/community/scottsdale/articles/2012/01/04/20120104scottsdale-podiatrist-develops-foot-ulcer-treatment.html)

 

Dr. Richard Jacoby, Medical Director at Scottsdale Neuropathy Institute, talks about how amniotic fluid can save diabetics’ feet.

We’re talking about diabetes and how there’s a huge problem with people having to have their feet amputated because of it. How many patients are getting amputations?

Dr. Jacoby: There are probably about 100,000 amputations every year in the United States due to that problem. It’s an incredible number, especially today in this world with modern medicine.

As a doctor, what is it like to have to tell someone they’re going to have to get their foot amputated?

Dr. Jacoby: It’s devastating. It’s devastating to tell people who have diabetes, which is the main reason of amputation in the United States, but they have no pain at the end of this process. So, for them it’s not that bad because they don’t have any pain; they just have an infection. They usually become septic so they’re happy to have that leg amputated. The real question is why do they get to that state in the first place? Why didn’t they have early intervention? What we’ve been working on is trying to find out if there is an earlier detection system for people with diabetic neuropathy and diabetes itself.

Can you explain the breakthrough wi“Amniotic Fluid Saves Feet” Dr. Richard Jacoby th amniotic fluid?