Connecting The Dots Between Diabetic Foot Ulcers, PAD And Dangerous Complications

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Author(s): 
Desmond Bell, DPM, CWS, FACCWS

   Connecting the dots between these conditions is necessary in formulating a proactive approach to managing patients with diabetes and preventing these catastrophic events. Early screening for PAD, before it becomes symptomatic, is essential in higher risk patients. These patients would include anyone age 50 or over who has diabetes and/or smokes, or those who are over the age of 70, even when health history of the individual is unremarkable. By coupling screening of these patient populations with early referrals to wound care specialists and vascular interventionalists, we can make significant strides toward reducing and preventing catastrophic events such as amputation, heart attack and stroke.

Final Notes

There must be greater accountability in terms of the treatment of diabetic foot ulcers and PAD. We must view these conditions in the same proactive manner as we do with breast cancer if any significant progress is to occur in the realm of limb preservation.

   Dr. Bell is a board certified wound specialist of the American Academy of Wound Management and a Fellow of the American College of Certified Wound Specialists. He is the founder of the “Save a Leg, Save a Life” Foundation, a multidisciplinary, non-profit organization dedicated to the reduction of lower extremity amputations and improving wound healing outcomes through evidence-based methodology and community outreach.

   The author thanks Mary Yost of the SAGE Group and Stephane Courric of Healiance for their contributions to this article.

References
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2. American Cancer Society, American Heart Association, Alzheimer’s Disease Education/Referral Center, American Diabetes Association, SAGE Group
3. Diabetic Foot Ulcers, Peripheral Arterial Disease and Critical Limb Ischemia. Available at http://thesagegroup.us/pages/reports/dfu-statistics.php .
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5. The NHS Information Centre. National Diabetes Audit: 2008–2009 audit analysis. Available at http://www.ic.nhs.uk/webfiles/Services/NCASP/Diabetes/200809 annual report documents/Dashboard 200809 - PCTs ranked nationally.xls .
6. Right Care, 2010. The NHS Atlas of Variation in Healthcare 2010. Available at http://www.rightcare.nhs.uk/atlas/qipp_nhsAtlas-HIGH_261110c.pdf .
7. The National Institute for Health and Clinical Excellence, 2011. Diabetic foot problems – Inpatient management of diabetic foot problems. NICE clinical guideline 11. Available at http://www.nice.org.uk/nicemedia/live/13416/53556/53556.pdf .
8. Allie DE, Hebert CJ, Lirtzman MD, et al. Critical limb ischemia: a global epidemic. A critical analysis of current treatment unmasks the clinical and economic costs of CLI. Euro Intervention J. 2005; 1(1):75-84.

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