Abdullah M Nasrat, Salwa AM Nasrat, Randa M Nasrat and Mohammad M Nasrat
The study aimed to illustrate the value of blood-let out cupping therapy in correcting early diabetic leg critical ischemia. Diabetic foot disease now replaced hyperglycemic coma as the major cause of diabetic mortality. The effect of medical treatment alone is far from ideal, especially in patients with diabetic foot complications; a high level amputation is inevitable. The real clue in a diabetic limb is preventing progress into complications rather than treating them. The challenge in the diabetic leg ischemia lies mainly in the accumulation of ischemic metabolites which would embarrass the micro-circulation by causing angiospasm. Withdrawal of these toxic metabolites and inflammatory mediators, being interstitial and diffuse, is not feasible via the available clinical measures; superficial scratching on the skin and suction by the traditional therapeutic cups is the only procedure to eliminate these acidic metabolites. Three patients with diabetic leg ischemia scheduled for above knee amputation due to complete unilateral obliteration of the vessels below the knee demanded an alternative solution for their conditions via cupping therapy. They were one male starting early acute ischemia of the right foot, a female starting gangrene of the right little toe and a male patient with early gangrene of the left heel. A basic cupping session on the upper back for the purpose of sero-clearance was done for them before the definitive cupping therapeutic sessions of the ischemic leg. Limb ischemia has been successfully corrected in all patients as documented by duplex ultrasound and amputation was cancelled. On conclusion, cupping therapy is promising in leg ischemia and is worthy of wider practical application.