"Knocking Socks Off" Saves Limbs and Lives, New Diabetes Study Shows

During Diabetes Awareness Month, the American Podiatric Medical Association encourages patients to see a podiatrist for regular foot examinations.

Bethesda, MD (Vocus) November 17, 2010

The number of Americans diagnosed with diabetes continues to rise toward record levels, with an estimated one in three adults predicted to have the disease by the year 2050 according to the Centers for Disease Control. Because many serious complications from diabetes present in the lower limbs, proper foot care for those with the disease is a vital step to keeping the disease in check. In fact, a new study on foot care for people with diabetes conducted by Thomson Reuters confirms that care by a podiatrist can drastically reduce the incidence of diabetes-related hospitalizations and amputations.

"During November's Diabetes Awareness Month, it's important to realize that simple lifestyle changes can go a long way toward staying healthy with diabetes. These include eating right, being active, monitoring blood glucose, and checking your feet daily," said Dr. Kathleen Stone, president of the American Podiatric Medical Association (APMA). "Diabetic foot complications are the leading cause of non-traumatic, lower-limb amputation in the U.S. Remembering to 'knock your socks off' at every doctor's visit will help to catch any potential lower limb complications early."

According to preliminary results from the Thomson Reuters study, those with diabetes who received care from a podiatrist had a nearly 29 percent lower risk of lower limb amputation, and 24 percent lower risk of hospitalization, than those who did not. APMA's "Knock Your Socks Off" campaign, running during Diabetes Awareness Month, aims to encourage everyone with diabetes and those at risk for the disease to remove their shoes and socks and inspect their feet and visit a podiatrist for a foot exam.

Feet should be checked regularly for signs and symptoms of diabetes to help prevent serious complications. Symptoms in the feet such as redness, tingling and cuts that are not healing can lead to diabetic ulcers and even possible amputation without prompt medical care.

"The Thomson Reuters study results show that just one visit to a podiatrist can drastically reduce the chance of a tragic diabetes-related amputation. There is now no question that a podiatrist must be a part of everyone's diabetes management team," Dr. Stone said. The APMA-sponsored study was conducted using Thomson Reuters' MarketScan Research Databases, which house fully integrated, de-identified health-care claims data extensively used by researchers to understand health economics and outcomes. Studies based on MarketScan data have been published in more than 130 peer-reviewed articles in the past five years.

Founded in 1912, the American Podiatric Medical Association (APMA) is the nation's leading and recognized professional organization for doctors of podiatric medicine (DPMs). DPMs are podiatric physicians and surgeons, also known as podiatrists, qualified by their education, training and experience to diagnose and treat conditions affecting the foot, ankle and structures of the leg. The medical education and training of a DPM includes four years of undergraduate education, four years of graduate education at an accredited podiatric medical college and two or three years of hospital residency training. APMA has 53 state component locations across the United States and its territories, with a membership of close to 12,000 podiatrists. All practicing APMA members are licensed by the state in which they practice podiatric medicine.

How Should a Diabetic Foot Ulcer Be Treated?

The primary goal in the treatment of foot ulcers is to obtain healing as soon as possible. The faster the healing, the less chance for an infection.

There are several key factors in the appropriate treatment of a diabetic foot ulcer:
Prevention of infection.
Taking the pressure off the area, called "off-loading."
Removing dead skin and tissue, called "debridement."
Applying medication or dressings to the ulcer.
Managing blood glucose and other health problems.
Not all ulcers are infected; however if the physician diagnoses an infection, a treatment program of antibiotics, wound care, and possibly hospitalization will be necessary.

There are several important factors to keep an ulcer from becoming infected:

Keep blood glucose levels under tight control.
Keep the ulcer clean and bandaged.
Cleanse the wound daily, using a wound dressing or bandage.
Do not walk barefoot.
For optimum healing, ulcers, especially those on the bottom of the foot, must be "off-loaded." Patients may be asked to wear special footgear, or a brace, specialized castings, or use a wheelchair or crutches. These devices will reduce the pressure and irritation to the ulcer area and help to speed the healing process.

The science of wound care has advanced significantly over the past ten years. The old thought of "let the air get at it" is now known to be harmful to healing. We know that wounds and ulcers heal faster, with a lower risk of infection, if they are kept covered and moist. The use of full strength betadine, peroxide, whirlpools and soaking are not recommended, as this could lead to further complications.

Appropriate wound management includes the use of dressings and topically-applied medications. These range from normal saline to advanced products, such as growth factors, ulcer dressings, and skin substitutes that have been shown to be highly effective in healing foot ulcers.

For a wound to heal there must be adequate circulation to the ulcerated area. The physician can determine circulation levels with noninvasive tests.