Diabetic Foot Ulcers

Mark Hinkes's picture

em>By Dr. Mark Hinkes, DPM

On June 27, 1991, the International Diabetes Federation (IDF) and World Health Organization (WHO) proclaimed the first World Diabetes Day. Today, World Diabetes Day is celebrated worldwide as an acknowledgement of the condition, symptoms, complications, treatment and resolve to find a cure for the disease. Participants in the celebration include 230 member associations of the International Diabetes Federation in more than 160 countries and territories. All Member States of the United Nations as well as other associations and organizations, companies, health care professionals and people living with diabetes and their families also observe World Diabetes Day. World Diabetes day will be celebrated on Friday, November 14th this year.

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Michel Hermans's picture

By Michel H.E. Hermans, MD

The CDC recently published encouraging data in the New England Journal of Medicine about a decline in the rate of five major complications related to diabetes mellitus: hyperglycemia, heart attack, stroke, kidney failure and amputations1. The report did not include eye-related problems (i.e. retinopathy, glaucoma, cataract). The rate of amputations went down from approx. +/- 55/10.000 adults (1990) to +/-26/10.000 adults (2010). The 2010 numbers on amputations are roughly in line with a more recent publication by the Agency for Healthcare Research and Quality (AHRQ) which reported an expected (2014) amputation rate of 3.75/person-year for type II and 3.8 for type I (figure I).

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Temple University School of Podiatric Medicine's picture

By James McGuire, DPM, PT, CPed, FAPWHc

The world of wound care is getting more complicated by the day. New products emerge almost weekly and further confuse the practitioner who is bombarded with ads and weekly visits from company representatives who tout the benefits of their particular collagen or foam.

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Mark Hinkes's picture

By Dr. Mark Hinkes, DPM

After you've checked vital signs – pulse, respiration, blood pressure and temperature – don't forget what's considered to be the fifth vital sign: PAIN. For patients with diabetes, one of the most challenging health problems is foot pain. Diabetic sensory neuropathy is the most commonly associated reason for foot pain in the patient with diabetes. However, there can be multiple and even overlapping etiologies that should be identified and evaluated before jumping to a conclusion.

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Mark Hinkes's picture

By Dr. Mark Hinkes, DPM

Twenty first century technology is helping people with diabetes to heal foot ulcers. An Australian colleague, for example, is developing an application that reminds people with diabetes to control their blood sugars with prompts and instructions, and allows them to upload a picture of their wound for their podiatrist to evaluate.

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Lydia Corum's picture

By Lydia A Meyers RN, MSN, CWCN

Diabetes is the number one cause of amputation for wound care patients. Individuals with diabetes need monitoring and education about the dangers they face on a daily basis due to their condition. Diabetic ulcers often begin with a simple bump, as a callous or by stepping on something.

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Laurie Swezey's picture

By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

Diabetic foot ulceration can lead to significant morbidity and mortality and is probably one of the most-feared complications of diabetes. Loss of limb (amputation) is a frequent outcome of diabetic foot ulceration.

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Thomas Serena's picture

By Thomas E. Serena MD, FACS, FACHM, FAPWCA

I had the honor of lecturing to an audience of mostly European physicians at the M.I.L.A.N. Diabetic Foot Conference this past February in Milan, Italy. My session this year focused on our current and ongoing research in point-of-care diagnostics. To date, we have enrolled more than a thousand patients in a dozen clinics across the United States. All of these trials led to the development of the first commercially available wound diagnostic, WOUNDCHEK (Systagenix, Gargarve, UK), approved in Europe last year (it has not yet received FDA clearance for use in the US). A revolutionary product, I imagined that it would have received rapid, wide-spread acceptance among my European colleagues. At the end of the presentation I asked for a show of hands: “How many of you are using the test in your clinics or hospitals.” In an audience of nearly one hundred, only three attendees raised their hands.

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David Hite's picture

By David Hite PhD

Diabetes, the leading cause of amputation of the lower limbs, places an enormous burden on both the individual and the health care system. It’s estimated that the annual cost for treating diabetic foot problems is over one billion dollars. During their lifetime, 15 percent of people with diabetes will experience a foot ulcer and about 20 percent of those will require amputation.

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Kim Coy Decoste's picture

By Kim Coy DeCoste RN, MSN, CDE

It can be quite concerning when you ask your patients attending a DSME class “How many of you have had your feet checked for blood flow and nerve function by your health care provider?”, and far less than half of them raise their hands. Probing a little further, you find that a number of patients have never even had their feet visually inspected by their health care provider (HCP) for signs of diabetic foot ulcers. This isn’t unique to my practice site. Recently when I was teaching a professional education program with diabetes educators from across the US, most in the group concurred with my findings.

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