Saving Lives and Limbs
by Natalie GutierrezPaula Shireman, M.D., assistant professor of surgery at the Health Science Center, sees firsthand the debilitating effects of diabetes every day. As a vascular surgeon, Dr. Shireman performs nontraumatic lower-limb amputations on diabetic patients at the Audie L. Murphy Division of the South Texas Veterans Health Care System. During a three-year period (1998-2000), surgeons performed 113 amputations at the VA hospital. Of those, 75 percent resulted from diabetes.
"Patients with diabetes often have such severe disease that leg amputation is their only option. If a diabetic patient has one leg amputated, he has a 50 percent chance of having his other leg amputated within four years," Dr. Shireman said. "It is frustrating for me as a surgeon to tell patients and their families that I cannot save their legs. Clearly, new treatments are needed to reduce amputation rates."
FACT: In 2000 and 2001, about 82,000 nontraumatic lower-limb amputations were performed annually among people with diabetes.
National Diabetes Fact Sheet 2003, U.S. Centers for Disease Control and Prevention
Dr. Shireman is on a mission to decrease the number of limbs lost to diabetes. She is the principal investigator on several research studies in the department of surgery that focus on atherosclerosis-induced ischemia, the hardening of the arteries that is one of the complications of diabetes and the leading culprit in lower-limb amputations. The National Heart, Lung and Blood Institute of the National Institutes of Health (NIH), the U.S. Department of Veterans Affairs and the Texas affiliate of the American Heart Association have funded these projects for a collective total of $2.5 million over five years.
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