/publications/issue/2005/2005-11/2005-11-5001

Program Aims to Spare Feet

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HIP is taking aggressive steps to help patients with diabetes prevent foot and ankle ulcers. The health care provider is screening 6500 of its patients who are at high risk for developing foot ulcers. For example, some patients may receive new orthotic shoes or a new device that makes it easy to check the skin temperature at the bottom of their feet every day. The device comes with instructions to telephone immediately if either foot is warmer than 90˚F, or if one foot is 4˚F warmer than the other. Either reading is an early indicator that an ulcer is developing.

HIP's goal is to dispel assumptions about the pressure wounds to ankles and feet that are among the most incapacitating symptoms of the disease. These injuries, which may force patients into early retirement and hamper their mobility, frequently become infected. Physicians have seen amputation as expected for many patients with foot ulcers. Yet, research has suggested that 50% to 85% of diabetic foot amputations are preventable. "We see amputation as a failure, not the expected outcome," said Barry H. Kohn, MD, medical director for care management at HIP.