CAN DIABETIC FOOT AMPUTATIONS BE PREVENTED?

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FACTS

1. 24 million people in the United States are affected by diabetes mellitus.

2. Diabetic foot infections comprise 20% of all diabetes-related hospital admissions.

3. Neuropathic ulcers (ulcers resulting from callus breakdown) are the most common diabetic foot manifestation leading to a lower extremity amputation.

4. Neuropathic ulcers are a consequence of ulcers developing as a result of foot deformity, sensory neuropathy, and microtrauma from everyday walking.

5. 15% of all diabetes patients will experience a neuropathic ulcer during their disease course.

6. Lower extremity amputations are 15% more common in the diabetic population.

RISK FACTORS FOR DIABETIC FOOT COMPLICATIONS

1. Duration of diabetes (>15 years)

2. Poor diabetes control (HGAIC >9)

3. Past history of foot ulcerations and amputations

4. Peripheral neuropathy (sensory loss)

5. Foot deformity (bunions, hammertoes)

6. Thick fungal nails

7. Dry callused skin

8. Limited joint mobility (rigid foot/ankle)

9. Peripheral vascular disease (poor circulation)

10. Risk factors for developing peripheral arterial disease: high cholesterol, high blood pressure, high fatty diet, heart disease, high triglycerides, smoking

HOW DOES ONE PREVENT AN AMPUTATION?

1. Acknowledge that the consequences of diabetes mellitus extend beyond poor sugar control,
and that alterations in glucose metabolism cause dysfunction in many organ systems (kidney, heart, nerve, eyes, and feet).

2. Acknowledge that among these complications, none is more common, complex and costly than the diabetic foot infection.

3. Accept one's vulnerability to diabetes-induced complications.

4. Obtain a podiatric consultation to identify the risk factors that preclude diabetic foot ulcers and infections.

5. Ask Dr. Cavazos to educate you on how diabetes affects your feet.

6. Have RGV Footcare implement a comprehensive treatment plan to address the risk factors leading to amputation.

The focus of diabetes care must shift from complication management to disease awareness, risk factor assessment, patient education, and preventative medicine implementation.

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