Volume 16 - Issue 3 - March 2003

Feature »

Expert Insights On Painful Diabetic Neuropathy

Moderator: David G. Armstrong, DPM; Panelists: Andrew Boulton, MD, A. Lee Dellon, MD, Jeffrey Page, DPM and Barry Rosenblum, DPM | 7791 reads | 0 comments

Painful diabetic neuropathy is perhaps one of the most discussed and hotly debated subjects in podiatry. Emerging research and emerging treatments have fueled the fire even further. With this in mind, David G. Armstrong, DPM, a member of the American Diabetes Association’s National Board of Directors, posed a number of questions to leading authorities on this controversial subject. Here’s what they had to say …

Q: How prevalent is painful diabetic neuropathy in your practice?
A:
All of the panelists note they see a large number of patients with neuropathy secondary to diabete



Feature »

How To Treat Onychomycosis In Diabetic Patients

By Richard A. Pollak, DPM, MS | 14347 reads | 0 comments

Diabetes mellitus is a major health problem in the United States, afflicting approximately 17 million people, with 1 million new cases diagnosed each year in people 20 and older.1 Patients with diabetes are at increased risk for toenail onychomycosis, which can cause discomfort, interfere with mobility, impair quality of life and lead to serious secondary infections and subsequent complications.2
Recent large epidemiological studies have shown the prevalence of onychomycosis in the diabetic population to be as high as 35 percent, compared to estimates ranging from 2 to 1



Feature »

What You Should Know About Type 2 Diabetes And Kids

By Eric Espensen, DPM, and Minh Mach, MD | 6082 reads | 0 comments

The prevalence of diabetes, especially that of type 2 in children, is increasing at an alarming rate worldwide. Although no data currently exists to determine the extent to which type 2 diabetes has emerged among U.S. children and adolescents, researchers at the Centers for Disease Control and Prevention estimate that among new cases of childhood diabetes, the proportion of those with type 2 diabetes ranges between 8 percent and 43 percent.1



Diagnostic Dilemmas »

Diagnosing Repeated Lower Extremity Ulcerations

Guest Clinical Editor: Tamara Fishman, DPM | 5150 reads | 0 comments

A patient’s medical history can provide you with critical information that is necessary to differentiate among the various types of lower extremity ulcerations. Not only are there many different etiologies of lower extremity ulcers, it’s also important to be aware of the patient’s underlying medical conditions as well, as you will see in the following case study.
A 38-year-old Caucasian female patient recounted her underlying medical conditions when she came in for evaluation and treatment of her left leg ulceration. She injured the side of her leg while walking and had the ulceration f



Editor's Perspective »

Unraveling The Controversy Over Diabetic Footwear

By Jeff Hall, Editor-in-Chief | 3112 reads | 0 comments

How helpful is therapeutic footwear for patients with diabetes? It has been one of the most hotly debated questions over the last few months, especially in the aftermath of a controversial study that was published last year in the Journal of the American Medical Association (JAMA). (See “Study Questions Necessity Of Diabetic Footwear,” News And Trends, August 2002.)
The randomized study of 400 people who had diabetes and a history of foot ulcers had three study groups. One group wore therapeutic shoes and custom inserts, another group wore therapeutic footwear and prefabricated



Forum »

Why I Chose The Road Less Traveled

By John McCord, DPM | 4335 reads | 0 comments

My patient was a 40-something, peroxide blonde, personal fitness trainer. It was her first visit and she complained, “You have to do something about my nails. I can’t have this flaw with my job.” Her nails looked nearly normal with only slight thickening and very faint yellow discoloration. She had a history of liver dysfunction. I explained that her problem wasn’t serious enough to treat and the oral medications for fungus nails were contraindicated because of her health history.
At this point, Blondie screamed at me because I had nothing to cure her nails. I sat back and made a few