Program Aims to Spare Feet

HIP is taking aggressive steps to helppatients with diabetes prevent foot and ankleulcers. The health care provider is screening6500 of its patients who are at high risk fordeveloping foot ulcers. For example, somepatients may receive new orthotic shoes or anew device that makes it easy to check the skintemperature at the bottom of their feet everyday. The device comes with instructions to telephoneimmediately if either foot is warmer than90˚F, or if one foot is 4˚F warmer than the other.Either reading is an early indicator that an ulceris developing.

HIP's goal is to dispel assumptions about thepressure wounds to ankles and feet that areamong the most incapacitating symptoms ofthe disease. These injuries, which may forcepatients into early retirement and hamper theirmobility, frequently become infected. Physicianshave seen amputation as expected formany patients with foot ulcers. Yet, researchhas suggested that 50% to 85% of diabetic footamputations are preventable. "We see amputationas a failure, not the expected outcome," said Barry H. Kohn, MD, medical director forcare management at HIP.