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Detecting And Treating Patients With Diabetic Autonomic Neuropathy

By Damieon Brown, DPM and Javier La Fontaine, DPM | 19,048 reads | 0 comments | 07/03/2004

Autonomic neuropathy may significantly affect the quality of life of patients with diabetes. Unfortunately, despite the common prevalence of this condition in this population, autonomic neuropathy is one of the least understood and recognized complications of diabetes. Not only is there a cloudy picture in regard to the pathogenesis of the condition, there are various clinical manifestations with no degree of consistency in which they may occur. With this in mind, let’s take a closer look at this potentially serious complication among people with diabetes.

Neurostimulation: Can It Have An Impact For Painful Diabetic Neuropathy?

Richard Brietstein, DPM, FACFAS, Neil Strauss, DPM, and Alexandra Andes, DPM | 17,889 reads | 0 comments | 05/20/2010

While current modalities for the symptoms of painful diabetic neuropathy include oral medications, topical therapies and surgical treatment, emerging research suggests the potential benefits of neurostimulation. Accordingly, these authors review the current literature and offer insights on proper patient selection for appropriate referrals.

Are DPMs Underusing The TCC To Offload Diabetic Foot Ulcers?

David G. Armstrong DPM MD PhD | 2,039 reads | 0 comments | 07/15/2014

Despite the evidence supporting the efficacy of total contact casts (TCC) to offload diabetic foot ulcers, podiatric physicians may not be putting this evidence into practice, according to a recent study.

Can Nerve Fiber Density Testing Facilitate Earlier Treatment Of Diabetic Neuropathy?

By Allen Mark Jacobs, DPM, FACFAS, FAPWCA­­ | 22,624 reads | 0 comments | 11/26/2008

   Intraepidermal nerve fiber density testing is gaining enthusiastic acceptance for the diagnosis as well as the staging of diabetic neuropathy. Studies have demonstrated reduced intraepidermal nerve fiber density in patients with diabetes type 1 and type 2.1 One major advantage of intraepidermal nerve fiber density testing is the ability to detect the presence of evolving peripheral neuropathy in the presence of normal neurophysiologic studies. 2

Are We Overdoing It With Antibiotics When Treating Osteomyelitis In The Diabetic Foot?

David G. Armstrong DPM MD PhD | 3,110 reads | 2 comments | 12/05/2014

Are we overmedicating patients with osteomyelitis in the diabetic foot? A new study in Diabetes Care suggests this is the case, noting that a six-week antibiotic regimen works just as well a 12-week course.1

Current Concepts In Diagnosing Chronic Diabetic Foot Ulcerations

Molly Judge, DPM, FACFAS | 13,988 reads | 0 comments | 02/24/2014

Offering pearls from the literature as well as her clinical experience, this author discusses the impact of infection, reviews common diabetic dermatopathology and notes other pertinent diagnostic keys.

Beginning with the initial patient presentation, there are a number of keys to manage chronic diabetic foot ulcerations. The first of these is the ability to make a definitive diagnosis.

Essential Pearls On Treating Diabetic Ankle Fractures

Keith D. Cook, DPM, FACFAS, Carl Brandon Lindberg, DPM, and Joseph Genualdi, DPM | 6,470 reads | 0 comments | 02/24/2014

Ankle fractures are very common injuries that foot and ankle surgeons see. An estimated 585,000 ankle fractures occur in the United States each year and 25 percent receive surgical intervention.1 Ankle fractures are the most common intraarticular fracture of a weightbearing surface and account for 9 percent of all fractures.1

Adapting To New Paradigm Shifts In Treating Patients With Diabetes And Peripheral Vascular Disease

Guy R. Pupp, DPM, FACFAS | 7,308 reads | 0 comments | 07/22/2013

The past few years have produced a plethora of studies, publications and lectures on the combination of diabetes and peripheral vascular disease, and their impact upon the lower extremities. One recent study looking at over 600 patients with diabetic foot ulcers and severe peripheral arterial disease (PAD) who did not have revascularization found that one-third of patients died unhealed.1

Are Lower Diabetic Amputation Rates In Italy A Cause For Hope?

David G. Armstrong DPM MD PhD | 2,559 reads | 0 comments | 04/16/2014

As the prevalence of diabetes rises, more people will face the complications of diabetes, including lower extremity amputation. However, there may be a ray of hope in the form of a recent study in PLOS One that notes a significant reduction in amputation rates among patients with diabetes in Italy.1

A Closer Look At Beaming The Columns In The Charcot Diabetic Foot

William P. Grant, DPM, FACFAS, Bryan Barbato, BS, and Lisa M. Grant-McDonald, BS | 23,952 reads | 0 comments | 02/24/2014

In the unstable Charcot foot, the concept of beaming may help patients with diabetes attain stability and greater weightbearing. These authors discuss the pathway of Charcot neuroarthropathy and offer essential surgical pearls.