On the opening day of the Virtual 80th Scientific Sessions, a panel of experts will discuss various clinical tools for managing the diabetic foot and preventing foot ulceration—a condition one-third of diabetes patients develop during their lifetimes.
The gravity of the problem is underscored by the fact that the five-year mortality rate for patients with diabetic foot complications is comparable to cancer mortality rates, according to Ryan T. Crews, MS, CCRP, chair of the session Diabetic Foot Management—Care Strategies for the Primary Care and Medical Teams, which will begin at 4:15 p.m. CT Friday, June 12. The session’s presenters will emphasize the need for more education, research, and prevention to help relieve the quality-of-life and other burdens these patients face.
“The need for knowledge and the push for knowledge is so great in the clinical and medical setting, but we’ll also talk about how we need the same push for patient education, patient compliance, and self-efficacy,” said presenter Timethia Bonner, DPM, PhD, ORISE Fellow/Performance Improvement and Evaluation Team at the Centers for Disease Control and Prevention.
Dr. Bonner will review several clinical interventions that she believes can improve management of the diabetic foot, including diabetes self-management education and support, foot care intervention, and telehealth. Crews, an Assistant Professor in the Department of Podiatric Surgery and Applied Biomechanics at Rosalind Franklin University of Medicine and Science, will discuss offloading devices for diabetic foot ulcers during the two-hour virtual presentation.
“I will discuss what is known about offloading devices from both a biomechanical (functional) perspective as well as from the perspective of actual ulcer healing,” he said. “This will lead into a review of the most recent guidelines on offloading from the International Working Group on the Diabetic Foot (IWGDF). Lastly, means to improve future offloading outcomes will be discussed. If we are going to make societal advances in regards to offloading, we need to find ways to either increase the use of irremovable devices or improve the user experience with removable devices without substantially decreasing the functional offloading provided by removable devices.”
Michael Fralick, MD, PhD, SM, FRCPC, Assistant Professor in the Department of Medicine at the University of Toronto, will offer tips for navigating the risks of lower extremity amputation associated with antidiabetic medications. And Sicco A. Bus, PhD, will describe his lifelong research on preventing foot ulcers and amputations.
“We really need to increase focus on the prevention of foot ulcers,” said Dr. Bus, Head of the Human Performance Laboratory at the Academic Medical Center, Department of Rehabilitation, in Amsterdam, the Netherlands. “There’s way more resources for the treatment of ulcers and complications than on the prevention, even though we know we are able to prevent a lot of them.”
A trial in the Netherlands, for example, showed that patients wearing prescribed footwear to reduce high-pressure points had a 50% reduction in ulcers.
Dr. Bus, Chair of the IWGDF, will also review the groups’ guidelines published in March on the prevention and management of diabetic foot disease.