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.
We have all bemoaned non-adherent patients with out-of-control blood sugars who nod agreeably and then ignore everything we say. Not surprisingly, their wounds heal poorly and discouragement sets in with these patients. Their behavior appears to defy logic until we look at how prevalent depression and anxiety disorders are among patents with diabetes and how these disorders... Read More.
Gene therapy has entered the forefront of medicine and there may be potential benefits in all fields of healthcare. The potential for gene therapy to target disease has vastly expanded since the first successful human treatment for severe combined immune deficiency (SCID) emerged in 1990.
In podiatric medicine, one proposed target that has devastating... Read More.
For better or for worse, we live in an “As Seen on TV” culture. Often, our patients come to us with their own thoughts and ideas based on a commercial that they saw on late night television, an advertisement from the magazine on an airplane or something that they have “researched” on the Internet.
We would venture to guess that a week does not go by when a... Read More.