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Friday, March 23, 2007

Grey's: We Must Amputate Diabetes
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While there are many wonderful things to focus on about this episode of Grey's Anatomy -- other than the aftermath of Izzy and George -- I am a good WebMDer and I am going to take this opportunity to highlight the diabetes/amputation storyline.

First, let's layout some plain not-in-the-episode-but-vital-to-your-understanding facts about diabetes in today's America.

According to the Centers for Disease Control, as of 2005 there were 20.8 million people with diabetes. What does that mean? Seven percent of the population has it. Of that number, it's estimated that 6.2 million are undiagnosed -- meaning they don't know they have diabetes.

Okay so what is diabetes exactly? It's a metabolic disorder affecting how our bodies digest food. The body turns food to glucose and produces insulin to use the glucose correctly. Diabetes affects how we produce insulin -- either too little or none at all. You can't metabolize the glucose and it builds up. As the body loses its building blocks to work properly things begin to stop working altogether.

The thing is, diabetes doesn't kill folks. It's the complications from diabetes that get you.

About 65 percent of deaths in people with diabetes are due to heart disease. About 73 percent have high blood pressure, leading to strokes. Still others suffer through blindness, kidney disease, dental issues, complications when pregnant, and nervous system disease.

Which leads us to Grey's and Cristina's construction worker. He had his leg amputated because, basically, he has diabetes, says Melissa Conrad Stoppler, MD.

"Diabetes causes problems with both the transmission of nerve signals from the lower extremities (feet) and with the circulation of blood. A person who has nerve damage from diabetes may not feel the pain from a blister or minor injury to the foot, resulting in inadequate treatment and protection of the sore area. This allows the injury to become further inflamed and infected. High blood glucose levels can promote the infection, and the decreased blood flow impedes the wound healing process. In severe cases, the injury can progress to the point of tissue death, known as gangrene. An amputation may then be necessary since healing can no longer occur."


Also touching on the subject "things interns shouldn't do", Dr. Stoppler has a few words of caution. Obviously George and Izzie shouldn't commit adultery, but that is more a "things people shouldn't do" more than interns.

"But also medically, Meredith harvesting bone from someone's orbital (eye socket) area?! Cristina performing an amputation???!!! These are advanced procedures that would not, under any circumstances, be performed by interns fresh out of med school. Interns would only observe these things."


Again, just goes to show you, medicine at Seattle Grace is way above par.

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Posted by: Kathy_WebMD at 3/23/2007 10:47:00 AM

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