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.
As the prevalence of diabetes mellitus increases worldwide, there will be a concomitant increase in the development of the lower extremity manifestations of the disease process. In the United States alone, there are currently an estimated 24 million patients living with diabetes.1,2 Given the reported 15 percent lifetime incidence for the development of lower extremity... Read More.
Reportedly 23.6 million individuals in the United States (or 8 percent of the American population) are affected by diabetes.1 Many of those with diabetes will develop related comorbidities such as microvascular pathology in the retina, renal glomeruli and peripheral nerves. Other comorbidities include accelerated atherosclerotic microvascular disease affecting arteries that... Read More.
Sharp debridement is a critical step to promote healing and allow the body to repair chronic wounds as naturally and healthily as possible. Removing necrotic tissue and biofilm from the surface of chronic wounds converts chronic wounds into acute ones, effectively “resetting” the wound healing cascade and allowing the healing process to take place.
Successful... Read More.
It is estimated that Medicare spends $1.5 billion annually to treat diabetic foot ulcers (DFU).1 The debate continues on the cost effectiveness of immediate amputation in comparison with “conservative treatment” using a variety of modalities.
The cost of healing a DFU is related to its severity but detailed “cost to heal” data stratified by Wagner grade are... Read More.
Approximately 23.6 million people in the United States have diabetes, according to the 2007 statistics from the American Diabetes Association.1 Many of these patients have an associated comorbidity of obesity and, all too often, Achilles tendon contracture.
As we age, the tendon naturally tightens. However, diabetes exacerbates this tightening process as... Read More.
Before the advent of insulin, death from diabetes occurred early in the disease process. Now people with diabetes are living longer and long-term complications of the disease are more common. One such complication is Charcot arthropathy and since the early report by Jordan linking it to diabetes, the number of case reports has steadily increased.1
Although the... Read More.