More states are looking to cut Podiatry from their Medicaid programs. Unfortunately for many people this will end in disaster.
The long story short on this matter is that education, access to healthcare and early detection are the keys to decreasing the amputation rate in patients with Diabetes!! Yet, we are still cutting Podiatry from Medicaid programs!!
Diabetes is the leading cause (more than 50%) of nontraumatic lower extremity amputation in the United States. Significant risk factors for amputation are hyperglycemia, a longer duration of diabetes, older age, and the presence of neuropathy, peripheral vascular disease, or foot ulcer. Foot ulcers alone precede about 85% of these amputations.11–13 Peripheral neuropathy can occur in both types of diabetes (60% to 70%), but more severe cases are found in patients with type 1 diabetes.10 It was the most common complication found in this study (68%).
The higher percentage of ulcer and amputation observed in our study may be attributed to the lower levels of education, low socioeconomic status, high rates of obesity, and high rates of non-adherence as compared with national levels. According to recently published data, intensive multidisciplinary team management can reduce up to 50% of neuropathic foot ulceration.14 Early detection and proper management of foot ulcer will further reduce the risk of amputation. Recently, the US Department of Health and Human Services called for a 40% overall reduction in lower extremity amputations, including a reduction in the amputation rate for African-Americans from 10.2 per 1,000 to 6.1 per 1,000 by the year 2010 http://www.jarcet.com/articles/Vol2Iss2/Siddhiquispr02.htm
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