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Tag Archive: American diabetes association

1. “Etiology, Epidemiology, and Disparities in the Burden of Diabetic Foot Ulcers” from Diabetes Care

   January 20, 2023 5:42 pm Leave a Comment

   A recently published article in Diabetes Care, Etiology, Epidemiology, and Disparities in the Burden of Diabetic Foot Ulcers, is one of the most comprehensive reviews on the topic in the last several years. Disturbing trends in healthcare disparities for lower income and minority patient populations with diabetic foot ulcers (DFUs) are discussed. Another concern noted in the article is the uptick in the amputation rate in diabetes patients after some notable reductions in the 1990s and 2000s.  The importance of preventative care and screening is reviewed in detail. Specifically, diagnosing loss of protective sensation (LOPS) through testing with the Semmes-Weinstein monofilament and tuning fork is stressed in these patients due to the centrality of diabetic peripheral neuropathy (DPN) in the formation of most DFUs. These recommendations support the findings of our last article on the prediction of DFUs with these two screening tests.

   

2. ADA releases Standards of Care in Diabetes—2023

   December 17, 2022 3:36 pm Leave a Comment

   The American Diabetes Association just released their 2023 version of it’s Standards of Care in Diabetes. The Retinopathy, Neuropathy, and Foot Care: Standards of Care in Diabetes chapter again reflects the latest evidenced-based guidelines on the treatment of the diabetic foot. Some newer recommendations include topical oxygen therapy for recalcitrant diabetic foot ulcers and alpha lipoic acid for neuropathic pain. Testing patients with diabetes for Loss of Protective Sensation (LOPS) with a 10g monofilament and at least one other neurological screening tool is again advised. One of these approved methods includes vibration testing with the 128 Hz tuning fork or “similar device”. These guidelines are in agreement with our latest ETF research paper, Combined Utility of the Semmes-Weinstein Monofilament and the Timed Vibration Test in the Prediction of Diabetic Foot Ulcers.

   

3. ADA 2017 Recommendations for Neuropathy Screening

   January 1, 2017 1:21 pm Leave a Comment

   The company was gratified to learn that the American Diabetes Association’s new Standards of Medical Care in Diabetes recommendations for 2017 have advised screening of all diabetic patients for large fiber neuropathy with a 128Hz tuning fork. Furthermore, the recommendations cited testing both small and large fiber nerves. This welcome clarification better reflects our current understanding of diabetic peripheral neuropathy. Clinicians are advised that small nerve fiber screening may be done with temperature or pinprick testing. The standing recommendations for 10 gm monofilament testing and annual foot exams remains unchanged.

   The importance of these recommendations is underscored by a recent report in JAMA indicating that healthcare spending on diabetes topped a list of the 155 most common disease conditions in the U.S.. Previous research has demonstrated that spending on diabetic foot complications alone may be as high as 33% of the economic burden of diabetes on the U.S. healthcare system. Both these findings support the strategic implementation of aggressive prevention including diabetic foot exams.