When Patients Ask About Online Information On Products And Procedures

By Andrew J. Meyr, DPM and John S. Steinberg, DPM

   The second intervention is Y-DAN, which is described as a “gentle, slow-motion exercise,” similar to tai chi, that can reportedly help improve blood flow to the affected extremity.

   http://www.presstv.ir/detail.aspx?id=41449&sectionid=3510210. This Web site provides preliminary information on “a new anti-diabetes herbal medication, which can effectively treat diabetic foot ulcers.” Angipars™ is a new medication being “mass produced” in Iran and is reportedly available orally, topically or intravenously.

   We tried to dig a little deeper on this one but we could only find an article describing Angipars™ as some form of herbal extract known as semelil in a pharmacologic journal published by the Tehran University of Medical Sciences.2

   http://foothealth.about.com/od/diabetesfeet/a/compairfootmass.htm. This site describes the use of compressed air massage in the treatment for diabetic foot ulcerations. “Compressed air massage works similar to filling a car tire with air, except that the air goes on your skin and not in a tire.” It reportedly facilitates a temporary increase in the local vascular supply.

   http://www.sarkaritel.com/news_and_features/health/diabeticfoot.htm. This Web site provides a link to an article written by Sunita Govind, a health reporter in India, who offers important and much needed information about diabetic foot disease in that country. However, we did have one question when Govind reported that “a diabetic foot can lead to frog foot, ulcers, gangrene and ultimately amputation.” Despite our research, we were unable to determine the exact nature of what constitutes a “frog foot.”

In Conclusion

   While it is impossible to control all of the information that will reach our patients, it is our duty and responsibility to educate them and ourselves with regard to the questions that they bring us. Instead of laughing off these Web sites and not giving them a second thought, active physicians will take a step back and see what they can learn from the situation.

   For example, Wikipedia is probably not the best place for patients to look for answers to their questions about the diabetic foot. However, after reviewing the page, we went on an active search for better sources. We now refer patients with general questions to several Web sites including the American Diabetes Association (www.diabetes.org/type-1-diabetes.jsp), the American Podiatric Medical Association (www.apma.org/s_apma/sec.asp?CID=371&DID=17520), and the American Medical Association (http://jama.ama-assn.org/cgi/reprint/293/2/260.pdf).

   We took a second look at our most commonly utilized antibiotic regimens and decided to continue to follow the recommendations established by the Infectious Diseases Society of America with respect to diabetic foot infections.3 We then reviewed the recent peer-reviewed publications regarding nitric oxide, light therapy and hyperbaric oxygen treatments, so we could make up-to-date and evidence-based recommendations to our patients.4-22

   As another example, before visiting reversegangrene.com, we would have been unable to tell you that phytonutrients are compounds derived from plants that are thought to have health-protective effects.23-25 Although we cannot specifically comment on the Gangrene Clear-G Formula, one should not underappreciate the impact of nutrition on diabetes and wound healing.26-30 In regard to this Web site page, you would probably be surprised at the documented impact of tai chi exercises on diabetes.31-34

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