Should Patients With Diabetic Peripheral Neuropathy Do Weightbearing Exercise?

David G. Armstrong DPM MD PhD
3/13/13 | 2962 reads | 0 comments
Podiatric physicians can face a dilemma of whether patients with diabetic peripheral neuropathy can exercise due to insensitive feet. A recent study in The Foot says neuropathic patients can participate in some monitored exercise.1 Read More.

When Offloading Devices Are Harder To Remove, Are Wounds Easier To Heal?

David G. Armstrong DPM MD PhD
1/22/13 | 2413 reads | 0 comments
Here's an intriguing meta-analysis from a team in Adelaide in South Australia. In a recently published study in Diabetes/Metabolism Research and Reviews, Morona and colleagues compared different offloading devices for neuropathic foot ulcers in patients with diabetes.1 The researchers searched medical bibliographic databases, the Internet and reference lists from January 1966 to May 2012. They focused on systematic reviews and controlled studies comparing the use of different offloading devices. Read More.

Should We Revisit Accepted Endpoints In The Studies Of Modalities For Wound Healing?

David G. Armstrong DPM MD PhD
11/15/12 | 3093 reads | 0 comments
Despite the high cost and potentially grave complications of chronic cutaneous ulcers, the Food and Drug Administration (FDA) has not approved a new drug therapy for such ulcers in over a decade. Indeed, the mortality rate of chronic ulcers can eclipse that of many cancers. This begs the question: Should we apply the endpoints researchers use for drugs in cancer studies in a similar fashion to studies of modalities for chronic cutaneous ulcers? Read More.

Emphasizing a Proactive Multidisciplinary Approach To The Combination Of Neuropathic Ulcers And Peripheral Arterial Disease

David G. Armstrong DPM MD PhD
10/24/12 | 2814 reads | 0 comments
Joe Mills, MD, and I, along with many of our colleagues, have been struck with how our population has changed but our methods (and language) have not. We discussed this previously in a dendrogram (cluster analysis) from a study I co-authored with Lavery and Peters in 2008. (see http://www.ncbi.nlm.nih.gov/pubmed/18593392 ). Read More.

Emphasizing The Study Of Human Motion To Improve Patient Outcomes

David G. Armstrong DPM MD PhD
8/24/12 | 2442 reads | 0 comments
We are pleased to announce the formation of the Interdisciplinary Consortium on Advanced Motion Performance (iCAMP) at the University of Arizona. This consortium will be lead by Bijan Najafi, PhD, a biomedical engineer and renowned expert on human motion. Comprised of teams from podiatric and vascular surgery, orthopedics, nursing, geriatrics, anthropology and engineering, iCAMP researchers will be studying physical activity patterns, gait parameters and three-dimensional joint structures through high-tech sensors that are embedded in shirts, socks, straps and patches worn by patients. Read More.

Expanding The Use Of NPWT Beyond DFUs: What The Literature Reveals

David G. Armstrong DPM MD PhD
5/22/12 | 3036 reads | 1 comments
Recently, the use of NPWT has expanded beyond the treatment of diabetic foot ulcers. Negative pressure wound therapy improves the take of split-thickness skin grafts by acting as a bolster and preventing an accumulation of fluid beneath the graft site.1 In 2004, Moisidis and co-workers found that the quality of take for split-thickness skin grafts subjected to NPWT was qualitatively improved in 50 percent of the cases they studied.2 Read More.

Are Mild Wound And Diabetic Foot Infections Like Mild Cancers?

David G. Armstrong DPM MD PhD
4/18/12 | 3595 reads | 0 comments
I was listening to a superb talk recently by Otis Brawley, MD, for our TEDMED at University of Arizona simulcast. Dr. Brawley, the Chief Medical Officer for the American Cancer Society, was speaking about the dramatic overtreatment of prostate and some breast cancers when they were in their early stages. Late in the 18-minute talk, he recounted an anecdote that I had not heard. It had to do with Donald Gleason, MD, PhD, and a meeting he had more than 50 years ago. Dr. Gleason is best known for the eponymous "Gleason Score" for prostate cancer. Read More.

Highlights From The Recent DFCon Meeting

David G. Armstrong DPM MD PhD
4/6/12 | 3657 reads | 0 comments
Diabetes and diabetic foot experts from around the globe met March 15 to 17 at the tenth DFCon Global Diabetic Foot Conference in Los Angeles to share ideas on how to prevent lower limb amputations due to the complications of diabetes. Lee C. Rogers, DPM, and Joseph L. Mills, Sr., MD, were the course directors. More than 30 internationally known experts from 11 countries served on the DFCon faculty. The speakers offered a number of insights. Dr. Mills presented the details on WIFI, a proposed classification for diabetic foot ulcers: Read More.

Will U.S. Amputation Rates Continue To Fall In People With Diabetes?

David G. Armstrong DPM MD PhD
2/13/12 | 4905 reads | 0 comments
There may be some good news in regard to amputation rates in patients with diabetes in the United States. A recent study in Diabetes Care found that nontraumatic lower extremity amputation rates have decreased in patients with diabetes over age 40.1 Lin and colleagues found the amputation discharge rate per 1,000 people with diabetes was 3.9 in 2008 — down from 11.2 in 1996. Read More.