Sari Goldman, BS, Devin Poonai, Oendrila Kamal, BA, and Khurram H. Khan, DPM
When it comes to diagnosing and treating lower extremity issues in patients with diabetes, a thorough biomechanical evaluation is at the top of the list. More often than not, a current ulcer began as a superficial hyperkeratosis, which unfortunately developed in a patient whose ability to perceive the pain normally associated with such a lesion in a timely manner was compromised due to neuropathy... Read More.
Transmetatarsal amputation (TMA) is an effective procedure, which preserves limb length while treating forefoot pathology that necessitates amputation in patients with adequate circulation. Success rates range from 39.4 percent to 93.3 percent.1-14 The most commonly reported complications of a TMA are an equinus or equinovarus deformity of the residual foot, and recurrent ulceration.5,8,15-19... Read More.
With the recognition of limb salvage as a key to decreasing mortality and increasing the quality of life in patients with chronic non-healing ulcerations, the transmetatarsal amputation (TMA) has become a common procedure.1-4 The current epidemic of diabetes mellitus affects 7.8 percent of the population in the United States. Moreover, an additional 57 million individuals have been diagnosed with... Read More.
David A. Farnen, BS, and Stephanie C. Wu, DPM, MSc
The prevalence of diabetes is increasing rapidly and is expected to reach epidemic proportion over the next decade. Recent research estimates that the number of people diagnosed with diabetes will rise from 23.7 million to 44.1 million between 2009 and 2034.1 The Centers for Disease Control and Prevention (CDC) further predict that up to one-third of U.S. adults could have diabetes by 2050 if... Read More.
At the recent annual meeting of the American Podiatric Medical Association (APMA), Gibson and colleagues presented an elegant study confirming what is well known to all podiatric physicians. In patients with diabetes, the study authors noted that “care by podiatrists appears to prevent or delay lower extremity amputation and hospitalization.”1
Podiatric care may include the use... Read More.
Fifty million people in India have diabetes.1 This is nearly double the estimated 26 million in the United States who have the disease.2 Although 8 percent of the global diabetes population live in the U.S., America’s diabetes care spending totals more than 50 percent of total world expenditures on the disease.3 In contrast, only 10 percent of the 1.3 billion people in India have healthcare... Read More.
Recent data suggests that three visits to a podiatrist prior to development of an ulceration correlates with better overall outcomes with fewer hospitalizations and decreased associated healthcare costs for patients with diabetes.1 As the incidence of diabetes continues to rise among the general population, this study reinforces the value of the podiatric physician within the community and the... Read More.
In addition to optimal medical management, thorough preoperative preparation is the fundamental key to success in the surgical management of high-risk patients, such as those with diabetes. I have witnessed avoidable complications that have occurred due to a lack of attention in areas that may be mistakenly perceived as inconsequential.
During my fellowship, I learned several... Read More.
Jeffrey A. Niezgoda, MD, FACHM, FAPWCA, Kimberly Eldridge, RN, CWS, Richard Millis, PhD, Milton Kondiles, DPM, and Rebecca D. Snarski, PhD
For those with diabetes, careful management of blood sugar is imperative to prevent any number of complications, including those that contribute to poor wound healing, which is so common in diabetes.
One such problem is the development of foot ulcers, which reportedly affects 15 percent of individuals with diabetes.1,2 Diabetic foot ulcers are significant problems as they can... Read More.
There are currently 24 million Americans — approximately 8 percent of the entire population — living with diabetes.1 Nearly 1.6 million new cases of diabetes are diagnosed in people 20 years and older each year. It is estimated that the number of patients living with diabetes will double to an estimated 48 million people by 2050.1
As a consequence of this drastic increase in... Read More.
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.