Feet Can Last a Lifetime
National Hospital Discharge Survey data for
1994 indicate that 67,000 people with diabetes underwent one or more
lower-extremity amputations. Diabetes is the leading cause of amputation of the
lower limbs. Yet it is clear that as many as half of these amputations might be
prevented through simple but effective foot care practices. The 1993 landmark
study, the Diabetes Control and Complications Trial funded by the National
Institute of Diabetes and Digestive and Kidney Diseases, conclusively showed
that keeping blood glucose as close to normal as possible significantly slows
the onset and progression of nerve and vascular complications associated with
People with diabetes are vulnerable to nerve
and vascular damage that can result in loss of protective sensation in the
feet, poor circulation, and poor healing of foot ulcers. All of these
conditions contribute to the high amputation rate in people with diabetes. The
absence of nerve and vascular symptoms, however, does not mean that a patient's
feet are not at risk. Risk of ulceration cannot be assessed without careful
examination of the patient's bare feet.
Early identification of foot problems and
early intervention to prevent problems from worsening can avert many
amputations. Good foot care, therefore, is an essential part of diabetes
management -- for patients as well as for health care providers.
This kit is designed for primary care and
other health care providers who counsel people with diabetes about preventive
health care practices, particularly foot care. "Feet Can Last a
Lifetime" is designed to help you implement four basic steps for preventive
foot care in your primary care practice.
1. Early identificationof high risk feet.
2. Early diagnosisof foot problems.
3. Early interventionto prevent further deterioration that may lead to
4. Patient educationfor proper footwear and care of the feet.
The kit includes the tools you need to
identify and diagnose diabetes foot problems, to develop a management plan, and
to educate your patients.
- A foot screening form and instructions.
- Prescription forms to facilitate Medicare coverage of
- A review of current research.
- A list of additional resources.
- Patient education materials.