According to the American Podiatric Medical Association (APMA), “Every 30 seconds, a lower limb is lost due to diabetes-related complications. That comes to 2,880 legs and feet every day. Diabetes is an epidemic of national proportions, and currently affects nearly 24 million Americans. It is also a family affair, as the disease is commonly passed down from parents to children. Amputation and ulceration prevention has been a major focus by Medicare in order to reduce complications and contain costs. Patients should take advantage of Medicare’s initiative to help prevent complications caused by neuropathy and peripheral vascular disease. Diabetes may cause a decrease in circulation called peripheral vascular disease. This is similar to a drought were there is not enough water and causes things to die. If there is not enough blood flow, a wound may not heal or develop gangrene, or death to tissue. Diabetes may also cause peripheral neuropathy, which decreases the ability to detect a wound or sore. This may allow tissue breakdown and an ulceration to occur. Areas of increased pressure like calluses are especially at risk.

If there is an ulceration or wound to the feet it may difficult to heal due to these conditions. This has caused a significant amount of spending by Medicare that they have invested a large amount of funding in preventing wounds. The new recommendations are to do a Comprehensive Diabetic Foot Evaluation, CDFE, once a year. This is an examination that is dedicated to the evaluation of pressure to the feet, sensation and circulation. If there are signs of neuropathy or peripheral vascular disease, then patients may qualify for diabetic shoes with special insoles to decrease the pressure to the feet and risk of ulceration.

Other precautions that should be taken is to see a foot care specialist such as our podiatrists located in Howell, Edison, Carteret and Monroe, and to have toenails and calluses taken care of every couple of months. This prevents any problems with patients cutting themselves and allows the doctor to keep a close eye on any future concerns. It is also recommended that patient apply lotion to their feet on a regular basis and check their feet twice daily. If you are unable to see the bottom of your feet, use a mirror to check them. Also check the inside of your shoes, especially if little children are around as they may leave toys in there. If you or someone that you love has Diabetes, make sure that they are seen by a podiatrist in order to prevent amputation.

By Dr. Alison DeWaters