How to help diabetic patients avoid amputation

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Of the 14 million Americans who have diabetes mellitus, more than 2 million will at some point have foot ulcers. The prevalence of this complication, its impact on the activities of daily living, and the cost of treating it make it a problem of immense magnitude. Primary care physicians who emphasize prevention and early treatment of foot ulcers can greatly reduce the likelihood of serious sequelae. This article tells you what to look for in examining the feet, how to advise patients in foot care, and what to do if ulcers occur despite preventive efforts.

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Saleh M. Shenaq

Saleh M. Shenaq, MD Michael J. A. Klebuc, MD Daniel Vargo, MD Dr Shenaq (left) is associate professor of plastic surgery and residency program director and Dr Klebuc (right) is a resident in general surgery, Baylor College of Medicine, Houston. At the time this article was written, Dr Vargo (not pictured) was a surgical research fellow at Baylor; he is now a resident in general surgery, University of Wisconsin Medical School, Madison.

Michael J. A. Klebuc

Saleh M. Shenaq, MD Michael J. A. Klebuc, MD Daniel Vargo, MD Dr Shenaq (left) is associate professor of plastic surgery and residency program director and Dr Klebuc (right) is a resident in general surgery, Baylor College of Medicine, Houston. At the time this article was written, Dr Vargo (not pictured) was a surgical research fellow at Baylor; he is now a resident in general surgery, University of Wisconsin Medical School, Madison.

Daniel Vargo

Saleh M. Shenaq, MD Michael J. A. Klebuc, MD Daniel Vargo, MD Dr Shenaq (left) is associate professor of plastic surgery and residency program director and Dr Klebuc (right) is a resident in general surgery, Baylor College of Medicine, Houston. At the time this article was written, Dr Vargo (not pictured) was a surgical research fellow at Baylor; he is now a resident in general surgery, University of Wisconsin Medical School, Madison.