Diabetes Watch

William P. Grant, DPM, FACFAS, Lisa M. Grant, and Bryan R. Barbato, BS
| 5,585 reads | 0 comments
It is well understood that unremitting pressure is a major etiologic factor in both the creation and persistence of diabetic foot ulcers. Sensory neuropathy in combination with autonomic and motor neuropathy readily produces foot deformities with bony prominences and skin lacking normal protective sensibility. Further complicating the problem, alteration in tendon morphology and its function... Read More.
Andrew J. Meyr, DPM, Kelly Pirozzi, DPM, and Corine Creech, DPM
| 4,633 reads | 0 comments
Body mass index is an objective patient finding that is known to correlate with not only the development and outcome of diabetic foot ulceration but also perioperative and long-term patient morbidity and mortality.1 The Centers for Disease Control and Prevention (CDC) reported in 2010 that 35.7 percent of United States adults and almost 17 percent of youth are defined as obese based on the body... Read More.
Valerie L. Schade, DPM, AACFAS
| 6,113 reads | 0 comments
A myriad of products exists for the treatment of acute and chronic wounds. The primary goal with any of these products is rapid wound closure. Studies have shown that a lack of reduction in wound size at four weeks of treatment should prompt the provider to engage in advanced wound care modalities to accelerate the wound toward closure.1,2    Several advanced wound care products... Read More.
By Thomas Belken, DPM
| 4,610 reads | 0 comments
There are certain protocols/algorithms that physicians follow within the hospital setting. When a patient with diabetes comes into the emergency department with an infected ulcer, a cascade of events takes place: lab tests, X-rays, wound cultures, blood cultures and consults to the appropriate specialists. Medicine, infectious disease, vascular, endocrinology and podiatry personnel usually... Read More.
Jay G. Levine, DPM, and Bernie Chowdhury, BA, CHT
| 4,069 reads | 0 comments
Any podiatrists seeking better patient outcomes should consider adding hyperbaric oxygen therapy (HBOT) to their treatment options. The practice of putting patients inside a hyperbaric chamber — either a monoplace or a multi-place chamber — and having them breathe 100 percent oxygen while under increased atmospheric pressure is gaining currency, and is well documented in the scientific literature... Read More.
Andrew H. Rice, DPM, FACFAS, and Mallory Przbylski, DPM
| 6,326 reads | 0 comments
According to the Centers for Disease Control and Prevention (CDC), greater than 60 percent of non-traumatic lower extremity amputations occur in patients with diabetes.1 It is clear one can attribute this to diabetic foot ulcers (DFUs), soft tissue infection and osteomyelitis. Wounds that are arrested in the chronic phase of healing become susceptible to soft tissue and bone infection, and... Read More.
Robert G. Smith DPM, MSc, RPh, CPed
| 6,840 reads | 0 comments
Diabetes mellitus is associated with a progression of microvascular and macrovascular complications.1,2 It is understandable that with the progression of these diabetes-related complications, the consumption of medications to prevent and treat them would be greater in comparison to those age-matched individuals without diabetes mellitus.3,4 Often, the use of medication by patients with diabetes... Read More.
Caroline E. Fife, MD
| 7,709 reads | 0 comments
The Affordable Care Act (ACA), which the Supreme Court recently upheld, creates a new value-based payment modifier. Starting in 2015, this payment modifier will provide differential payments to doctors based on quality and cost of care. Since the payment adjustments are to be budget neutral, some physicians will receive bonuses and others penalties under this provision. It is likely that payment... Read More.
Karen Shum, DPM, Ronald Belczyk, DPM, Lee C. Rogers, DPM, George Andros, MD, and Larissa Lee, MD
| 6,861 reads | 0 comments
Diabetic ulcers, particularly those located in the forefoot region, pose an interesting challenge for the foot surgeon. When these ulcers occur in the neuropathic patient with adequate circulation, the pedicle flap of the great toe can serve as a useful tool for ulcer management.    Frequently, ulcerations located on the plantar aspect can be difficult to treat because of their... Read More.
Paul J. Liswood, DPM, FACFAS
| 7,628 reads | 0 comments
The care podiatrists provide for patients with diabetes is essential, improves outcomes and saves money. That is the value we provide. Now we have data that demonstrates this value. Last year, two independent studies, one by Carls and colleagues and the other by researchers at Duke University, confirmed this truth.1,2    As we embark on new healthcare delivery models and... Read More.
Alexander M. Reyzelman, DPM, and Irina Bazarov, MS
| 13,654 reads | 0 comments
Despite the multitude of wound healing products and technologies that have come out in recent years, the treatment of chronic diabetic ulcers still remains a challenge. An evolving scientific understanding of wound physiology has led to the introduction of new wound care products targeting specific wound healing abnormalities.    Unfortunately, the complexity of imbalances... Read More.
J. Monroe Laborde, MD, MS
| 11,080 reads | 0 comments
Diabetic neuropathy results in tendon imbalance and decreased protective sensation.1,2 Tendon imbalance, especially Achilles or gastrocnemius-soleus tightness, causes or aggravates most foot problems.3-7 Achilles tendon or gastrocnemius-soleus tightness causes increased stress in the foot.8,9 This stress can cause a callus and a subsequent forefoot ulcer.8 Increased stress in the foot less... Read More.