Foot Health and Diabetes

November 28, 2011 Updated Nov 28, 2011 at 9:35 AM EDT

By WKBW News

...
November 28, 2011 Updated Nov 28, 2011 at 9:35 AM EDT

BUFFALO, NY ( WKBW ) Podiatrist Dr. James Hanna told Patrick Taney and Ginger Geoffery on "Eyewitness News This Morning" that diabetes can sometimes be diagnosed by problems with your feet.

Click the video for the video visit.

Here is some information Dr. Hanna provided that you might need to know.

Thomson Reuters Study: “The Economic Value of Specialized Lower-Extremity Medical Care by Podiatric Physicians in the Treatment of Diabetic Foot Ulcers,” Journal of the American Podiatric Medical Association, Vol. 101, No 2, March/April 2011.

The study focused on one specific aspect of diabetic foot care:

• identifying individuals with diabetes who developed a foot
ulcer;


• of those who developed a foot ulcer, examining whether they had received any care 
from a podiatrist in the year prior to development of the ulcer.

The study compared individuals who had at least one visit to a podiatrist prior to developing the foot ulcer to those who had no podiatry care in the year prior to developing the foot ulceration.

Researchers stratified subjects into four stages based on disease severity:


• Stage One—Neuropathy, parasthesia, pain in feet,
diabetic amyotrophy;

• Stage Two—Cellulitis, Charcot feet;


• Stage Three—Ulcer; and


• Stage Four - Osteomyelitis, gangrene.

QUALITY OF CARE
Duke Study:
• Persons visiting a podiatrist and/or a lower-extremity clinician specialist within a year before developing all-stage complications were between 23 percent and 69 percent less likely to have an amputation compared with individuals who visited other health professionals.

• Podiatrists provide a unique and valuable service that is distinct from the services that allopathic and osteopathic physicians provide, and provide the highest benefit to those persons at risk of lower extremity complications as a consequence of diabetes.

• Conclusion: Care by a podiatrist and/or a lower extremity clinician specialist in the year before the lower extremity complication diagnosis reduced the potential for undergoing lower extremity amputation, suggesting a benefit from multidisciplinary care.
Thomson Reuters Study:

• Podiatrists see patients who are sicker and have more comorbidities.

• Among non-Medicare patients with foot ulcer, those seen previously by a podiatrist had a 20 
percent lower risk of amputation and a 26 percent lower risk of hospitalization compared with 
patients not previously seen by a podiatrist.

• Among Medicare eligible patients with foot ulcer, those seen by a podiatrist had a 23 percent 
lower risk of amputation and a 9 percent lower risk of hospitalization compared with patients
not previously seen by a podiatrist.

• Conclusion: Care by podiatrists prior to the first evidence of foot ulcers in patients with diabetes 
prevents or delays lower extremity amputations and hospitalizations. 


POLICY IMPLICATION 
Podiatrists receive the education, training, and experience necessary to provide quality foot and ankle care to patients, and at the same time present cost containment solutions to our health-care delivery and financing systems.

Moreover, when compared to other health care professionals who treat the diabetic foot, podiatrists are more likely to reduce hospitalizations and prevent amputations. 


Providing access to podiatrists is an important component in ensuring quality of care. The growing epidemics of diabetes and obesity and their concurrent complications, along with the aging of the population, are among the many reasons podiatrists are necessary and important members of the physician community and demand for their services is increasing.