On Lou Brock, diabetes, and the need for improved education on the condition

As reported by Rick Hummel for STLToday.com, back on October 27th, St. Louis Cardinals legend Lou Brock was forced into a decision that is becoming an all-too-common practice in the field of medicine. Brock, who was first diagnosed with type II diabetes roughly 16 years ago, had his left leg—an integral part of his Hall of Fame career (938 career stolen bases)—amputated below the knee, a necessary step in preventing a potentially life-threatening infection from spreading throughout his body.

Why couldn't doctors have treated Brock with an extensive course of antibiotics in hopes of saving his leg from amputation, you ask? Honestly, they probably went this route at first, but among many other symptoms, poor blood flow to one's extremities (arms, legs, fingers, etc.) is one of the primary culprits for causing major diabetes-associated complications. Infections arise in a diabetic patient's extremities (and are considered the most common cause of hospitalization for diabetics) largely because he or she is getting poor blood flow to the site, creating an ideal environment for bacteria to proliferate and eventually become a full-blown infection. With already poor blood flow to the affected area, antibiotics (both oral and intravenous) are unable to travel to the extremities in adequate quantities, severely hampering their ability to combat the infection.

Fortunately for Brock, the surgery appears to have been successful at containing and subsequently eradicating the infection from his body as he has been transferred, after a month-long stay in a hospital, to a rehabilitation center. Unfortunately, his battle with the condition is not over, though, because diabetes, especially in a poorly controlled state, will continue to wreak havoc on the human body. It is classified as a "chronic" disease for a reason.

Brock is not alone in his battle with diabetes, either. As reported by the American Diabetes Association (ADA), in 2012, 29.1 million Americans (9.3% of the population) had diabetes, with 90% of cases being type II (Brock's type). For those 65 years of age or older, the incidence of diabetes is even higher at 25.9%. The population of diabetics is ever increasing, too, as there are between 1.5 to 2 million new cases each calendar year. As fans of baseball, a game centered on statistical analysis, we all understand the significance of these numbers.

As a pharmacist in my day job, it is getting to a point where it seems like I am dispensing diabetic medications (from oral tablets to injectable insulins) just as frequently as blood pressure or cholesterol medications. Fortunately, this is a bit of an exaggeration as the prevalence of high blood pressure (29%) and high cholesterol (31.7%) is still greater than that of diabetes. But, diabetes' lower prevalence doesn't make the disease any less serious, especially considering these three often run together.

A need for education

If diabetes runs in one's family, one must be especially cognizant of the warning signs and symptoms—having to urinate frequently (polyuria), being consistently thirsty (polydipsia), and craving food regularly (polyphagia). Even if diabetes doesn't run in one's family, it does not hurt to get tested early and often (as type II diabetes can realistically "pop up" at any time), particularly if these any of the warning signs are present.

In rare cases, if diagnosed in its early stages (and unlike many medical conditions, diagnosing diabetes is fairly easy) and necessary lifestyle changes are addressed, type II diabetes can be reversed, as was reportedly the case with Arizona Cardinals defensive back Patrick Peterson. More commonly, though, patients will be prescribed medications (from oral tablets like metformin to injectable insulin like Lantus), which, if taken consistently, along with diet and lifestyle changes, can help keep the disease under control and potentially prevent major complications (i.e. leg amputation) from happening. Fortunately, diabetic medications are ever improving, and the amount of money spent on the research and development of new drugs is increasing every year.

Don't worry too much, though, because the necessary education on diabetes is readily available as well as there are plenty of reliable resources on the internet (starting with www.diabetes.org), along with knowledgeable medical professionals (doctors, pharmacists, and nutritionists) interested in helping each step of the way. Let's use the severity of Brock's condition and subsequent complication as evidence that diabetes can be detrimental to even the world's greatest athletes. It's time to get serious about diabetes management. One person at a time.