Hope C. Markowitz, BA, Harley B. Kantor, BA, Randy Cohen, DPM, and Khurram H. Khan, DPM
Making an accurate diagnosis of osteomyelitis in a patient with diabetes is essential in order to minimize complications. Nearly 33 percent of diabetic foot infections develop osteomyelitis. Most of these infections are a result of direct contiguous spread from soft tissue lesions.1
Early diagnosis and antibiotic therapy are important in order to prevent amputation. In healthy... Read More.
An international study of patients with diabetes presenting with incident foot ulceration identified the “critical triad” of peripheral neuropathy, trauma and foot deformity in the pathogenesis of approximately 63 percent of patients.1 The most common component was peripheral neuropathy, which was present in nearly 80 percent of the patients in this study.
Podiatric physicians... Read More.
Chronic lower extremity wounds are a significant complication of diabetes. Approximately 15 to 20 percent of people with diabetes will develop a diabetic foot ulcer in their lifetime.1 As the number of people diagnosed with diabetes continues to rise, so will the number of diabetic foot ulcers. It is estimated that the number of people diagnosed with diabetes will double to an... Read More.
Adam Lang, BS, and Kathleen Satterfield, DPM, FACFAOM
As podiatric physicians in 2010, we are better trained than ever to manage patients’ problems. Even more importantly, we are well versed in making appropriate, well-timed referrals when needed. In the following case study, that particular acumen was critically important.
A 78-year-old male with type 2 diabetes underwent resection of the first... Read More.
In recent years, there have been numerous studies that demonstrate the link between obesity and type 2 diabetes. Several studies have demonstrated that modest weight loss in at-risk patients with impaired glucose tolerance reduces the incidence of new diabetes nearly 60 percent over four years.1
Furthermore, research has documented that weight loss improves... Read More.
Nicholas J. Bevilacqua, DPM, and Lee C. Rogers, DPM
Up to 25 percent of people with diabetes will develop a foot ulceration at some point during their lifetimes.1 There are a number of component causes that interact to complete the causal pathway to foot ulceration. However, the most frequent component causes are peripheral neuropathy, deformity and trauma.2,3
Deformity leads to increased plantar pressures and... Read More.
Diabetic foot ulcerations are a significant public health concern and cause an increasingly heavy demand on our healthcare systems. Diabetic foot infections cause more than 300,000 admissions to hospitals each year, leading to approximately 92,000 amputations.1 The resulting wounds require intensive local wound care and are slow to heal, resulting in prolonged disability and... Read More.
Regardless of their specialty, clinicians will encounter patients who are affected by diabetes mellitus, infection and wound healing issues. Therefore, the emerging, evolving science of nanomedicine and how this technology could positively enhance patient outcomes would be of great interest to all physicians including DPMs.
The current literature has reported... Read More.
William B. Hoffman, BS, Khurram H. Khan, DPM, FAPWCA, and Mark Kosinski, DPM, FIDSA
Diabetic foot osteomyelitis continues to be one of the more challenging entities to diagnose and treat accurately. Although there are established clinical practice guidelines set forth by the Infectious Diseases Society of America (IDSA), deviations from these guidelines often exist from one treatment facility to the next.1
Many physicians continue to... Read More.
As the prevalence of diabetes mellitus increases worldwide, there will be a concomitant increase in the development of the lower extremity manifestations of the disease process. In the United States alone, there are currently an estimated 24 million patients living with diabetes.1,2 Given the reported 15 percent lifetime incidence for the development of lower extremity... Read More.
Reportedly 23.6 million individuals in the United States (or 8 percent of the American population) are affected by diabetes.1 Many of those with diabetes will develop related comorbidities such as microvascular pathology in the retina, renal glomeruli and peripheral nerves. Other comorbidities include accelerated atherosclerotic microvascular disease affecting arteries that... Read More.
Sharp debridement is a critical step to promote healing and allow the body to repair chronic wounds as naturally and healthily as possible. Removing necrotic tissue and biofilm from the surface of chronic wounds converts chronic wounds into acute ones, effectively “resetting” the wound healing cascade and allowing the healing process to take place.
Successful... Read More.