The growth of diabetes worldwide is alarming. The World Health Organization (WHO) expects the number of new diabetes cases to double in the next 25 years from 135 million to nearly 300 million. Much of this growth will occur in developing countries where aging, unhealthy diets, obesity and sedentary lifestyles will contribute to the onset of the disease.
Thomson Reuters’ MarketScan Research Databases recently conducted a study to examine whether outcomes of care (amputation and hospitalization) differ between patients with diabetes who received care from podiatrists and those who did not.
According to this first of its kind study, essential foot care by a podiatrist has been statistically proven to reduce hospitalization and amputation in diabetics. This research highlights the dramatic impact that even a single visit to a podiatrist can have on patients with diabetes.
The study examined records of more than 32,000 patients with diabetes, ages 18 to 64, and compared health and risk factors for those who had podiatry visits to those who did not. Researchers found that care by a podiatric physician (defined as at least one preventative, pre-ulcer visit) was associated with a nearly 29 percent lower risk of amputation and 24 percent lower risk of hospitalization.
Diabetic foot complications are the leading cause of non-traumatic lower limb amputation in the U.S.
The earlier a podiatrist is included in the diabetic management team, the better quality of life for the patient.
Prevalence of diabetes
A total of 23.6 million people, nearly 8 percent of the U.S. population, has diabetes. People diagnosed with diabetes reaches 17.9 million. Undiagnosed people reach 5.7 million. Prevalence of diabetes among people 20 years or older is 23.5 million. Nearly 11 percent of all people in this age group have diabetes.
People diagnosed age 60 years or older equals 12.2 million. Almost 23 percent of all people in this age group have diabetes. Twelve million men have it and close to 11 percent of all men, age 20 years or older, have diabetes; nearly one third do not know it.
For women, 11.5 million are diagnosed, equaling nearly 10 percent of all women age 20 years or older that have diabetes.
Diabetes by race
Nearly 15 percent, or close to 4 million, of all non-Hispanic blacks, age 20 years or older, have diabetes. On average, non-Hispanic blacks are 1.8 times more likely to have diabetes than non-Hispanic whites of similar age.
Nearly 11 percent of Hispanic/Latino-Americans age 20 years or older have diabetes. Mexican-Americans, the largest Hispanic/Latino subgroup, are almost two times as likely to have diabetes as non-Hispanic whites.
Close to 15 million, or nearly 10 percent, of all non-Hispanic whites, age 20 years or older, have diabetes.
Symptoms of diabetes may include frequent urination, excessive thirst, extreme hunger, unexplained weight loss, tingling or numbness of the feet or hands, blurred vision, fatigue, slow-to-heal wounds and susceptibility to certain infections.
People who have any of these symptoms and have not been tested for diabetes are putting themselves at considerable risk and should see a physician without delay. Part of keeping your diabetes in control is testing your blood sugar often.
Diabetes is the sixth leading cause of death by disease in the United States, and individuals with diabetes are two to four times as likely to experience heart disease and stroke. According to a recent survey, about 86,000 lower limbs are amputated annually due to complications from diabetes.
Diabetes is the leading cause of end-stage kidney disease, accounting for about 44 percent of new cases. Diabetes is also the leading cause of new cases of blindness among adults aged 20 to 74. While there is no cure for diabetes, there is hope. With a proper diet, exercise, medical care and careful management at home, a person with diabetes can keep the most serious of the consequences at bay and enjoy a long, full life.
If you have diabetes, make sure you take the following steps:
• Wash feet daily — Using mild soap and lukewarm water, wash your feet in the mornings and before bed each evening.
Dry carefully with a soft towel, especially between the toes, and dust your feet with talcum powder to wick away moisture. If the skin is dry, use a good moisturizing cream daily but avoid getting it between the toes.
• Inspect feet daily —Check your feet every day for cuts, bruises, sores or changes to the toenails, such as thickening or discoloration. If age or other factors hamper self-inspection, ask someone to help you.
• Lose weight — People with diabetes are commonly overweight, which nearly doubles the risk of complications.
• Wear thick, soft socks — Socks made of an acrylic blend are well suited but avoid mended socks or those with seams, which could rub to cause blisters.
• Stop smoking —Tobacco can contribute to circulatory problems, which can be especially troublesome to those with diabetes.
• Walk — As a means to keep weight down and improve circulation, walking is one of the best all-around exercises for the diabetic patient. Be sure to wear appropriate athletic shoes when exercising.
• Don’t go barefoot — Not even in your own home. Barefoot walking outside is particularly dangerous because of the possibility of cuts, falls and infection. When at home, wear slippers.
• Never try to remove calluses, corns, or warts by yourself — Commercial, over-the-counter preparations that remove warts or corns should be avoided because they can burn the skin and cause irreplaceable damage to the foot. Never try to cut calluses with a razor blade or any other instrument because of the risk of cutting yourself, and such wounds can often lead to more serious ulcers and lacerations.
Dr. Patricia Chapman is a certified podiatrist.