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New Diabetes Guidelines Target Foot Complications, Amputations

Posted: Thursday, September 28, 2006

New guidelines for health care professionals could lead to significantly fewer foot complications and amputations by changing the way doctors treat the feet of diabetes patients.

The new guidelines from the American College of Foot and Ankle Surgeons (ACFAS) introduce two substantial changes since their last publication in 2000: a focus on prevention, and the use of multidisciplinary teams of specialists.

The changes reflect medical evidence from around the world that a multidisciplinary team approach achieves dramatic reductions in complications and amputations in diabetic feet. They also mirror an increasing emphasis on management of chronic diseases like diabetes. You will begin to see more podiatists getting more involved with the care of their patients with diabetes.

The ACFAS published the guidelines as a supplement to the current issue of the Journal of Foot & Ankle Surgery.

“These state-of-the-art guidelines give foot and ankle surgeons and other medical professionals a powerful new tool to help improve and maintain the quality of life for millions of people with diabetes,” says James L. Thomas, DPM, FACFAS, a Birmingham, Ala. foot and ankle surgeon and president of the ACFAS. “But they don’t erase patients’ responsibility to manage their disease, inspect their feet daily, and get regular check-ups.”

The ACFAS Web site FootPhysicians.com notes many diabetic foot problems are caused by complications of the disease, such as poor blood circulation and nerve damage. The guidelines provide doctors a decision-making roadmap for treating three major problems that can lead to amputations:

• Ulcers, or sores that don’t heal. They are the most common diabetic foot complication, with treatment costing an estimated $5 billion in the United States. Foot ulcers are the most common cause of diabetic hospitalizations and toe, foot and leg amputations.
• Infections, the second most-common diabetic foot complication. Diabetes patients who suffer nerve damage in their feet do not feel pain from ulcers, cuts and puncture wounds that allow bacteria to enter.
• Charcot foot, a severe foot deformity involving a collapse of the foot’s structure, affects less than one percent of people with diabetes, but can lead to amputation.

Other diabetes-related foot and leg problems include corns and calluses, dry, cracked skin, nail disorders, hammertoes and bunions, brittle bones and blocked arteries in the calf.

The American College of Foot and Ankle Surgeons (ACFAS) is a professional society of more than 6,000 foot and ankle surgeons. Founded in 1942, the College’s mission is to promote research and provide continuing education for the foot and ankle surgical specialty, and to educate the general public on foot health and conditions of the foot and ankle through its consumer website, http://www.footphysicians.com.

Source: Diabetes In Control