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.
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.