What Studies Reveal About The Preventive Value Of Podiatric Care For Patients With Diabetes

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Paul J. Liswood, DPM, FACFAS

   A qualified podiatrist should assign every patient with diabetes a risk classification. Individual podiatrists must take it upon themselves to perform the evaluations.

Final Notes

As doctors of podiatric medicine, it is all of our responsibilities to show the medical community, governmental agencies and insurance companies the important role podiatrists play as part of the healthcare team.

   The New York State Podiatric Medical Association, on which I serve as a trustee, has been on a campaign to do just that. We have presented the aforementioned study data to the New York State Health Commissioner as well as representatives of the governor’s office. We sent summary sheets of the study data to all New York State legislators. We have made presentations to insurance executives as well as health foundations. We are empowering our members with materials to speak to referring physicians and patients on the importance of podiatry care for patients with diabetes.

   However, it does not have to be only a large-scale effort by a state podiatry association to make a difference. All podiatrists could help get the word out. By educating the public and the medical community on what we do, podiatry’s role in patient care will expand. The goal is to have all patients with diabetes receiving lower extremity care from a podiatrist. Patients will benefit and the U.S. healthcare system will as well. The results will be significant cost savings, ulcer prevention and reductions in amputations.

   Dr. Liswood serves as a Trustee of the New York State Podiatric Medical Association. He is a member of a special task force created to inform governmental agencies, healthcare payers and the public about the results of the Thomson Reuters and Duke University data. Dr. Liswood is a Fellow of the American College of Foot and Ankle Surgeons.

1. Carls GS, Gibson TB, Driver VR, et al. The economic value of specialized lower-extremity medical care by podiatric physicians in the treatment of diabetic foot ulcers. J Am Podiatr Med Assoc. 2011;101(2):93-115.
2. Sloan FA, Feinglos MN, Grossman DS. Receipt of care and reduction of lower extremity amputations in a nationally representative sample of U.S. elderly. Health Serv Res. 2010;45(6 Pt 1):1740-1762.
3. Driver VR, Fabbi M, Lavery LA, Gibbons G. The costs of diabetic foot: the economic case for the limb salvage team. J Am Podiatr Med Assoc. 2010;100(5):335-341.
4. Rogers LC, Andros G, Caporusso J, et al. Toe and flow: essential components and structure of the amputation prevention team. J Am Podiatr Med Assoc. 2010;100(5):342-348.
5. Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA. 2005;293(2):217-28.
6. Rogers LC, Lavery LA, Armstrong DG. The right to bear legs — an amendment to healthcare: how preventing amputations can save billions for the U.S. health care system. J Am Podiatr Med Assoc. 2008;98(2):166-168.
7. Iversen MM, Tell GS, Riise T, et al. History of foot ulcer increases mortality among individuals with diabetes: ten-year follow-up of the Nord-Trondelag health study, Norway. Diabetes Care. 2009;32(12):2193-9.
8. Boulton AJ, Armstrong DG, Albert SF, et al. Comprehensive foot examination and risk assessment: a report of the task force of the foot care interest group of the American Diabetes Association, with endorsement by the American Association of Clinical Endocrinologists. Diabetes Care. 2008:31(8):1679-85.

   For further reading, see “Emphasizing The Multidisciplinary Approach To Diabetic Limb Salvage” in the November 2008 issue of Podiatry Today or “Preventing Amputation In Patients With Diabetes” in the March 2008 issue.

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