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| |  Effective Amputation Prevention Begins With Initial Diabetes Diagnosis LONG ISLAND, N.Y.-- Nov. 4, 1996 -- Amputations Could Be Reduced 50 Percent. As many as half of the 16 million people with diabetes have or will develop neuropathy, or nerve damage in their legs and feet, that can lead to injuries or ulcers - and even amputations for an estimated 54,000 patients annually in the U.S. Patient education about this condition beginning at the initial diagnosis of diabetes and routine testing provides the best means of preventing amputation, according to George Deitrick, M.D., vice president of medical affairs for Curative Health Services, which manages a national network of more than 100 Wound Care Centers that treat diabetic-related complications. November is National Diabetes Month and the educational focus for 1996 is the prevention of complications related to diabetes. "Patients' awareness of the condition and active participation in their own care is as important with neuropathy as it is in their self-management of diabetes as a whole. Knowledge of the warning signs for neuropathy and the preventive measures to avoid or lessen injuries, sores, and infections is the 'first line of defense' in amputation prevention," said Deitrick. "Routine testing for nerve damage - with a simple test from one to four times a year -- by patients' physicians and clinical staff is equally important to avoiding amputations," added Deitrick. The American Diabetes Association estimates that diabetic-related amputation could be reduced by 50 percent if patients were routinely tested for neuropathy, educated to prevent injury or complications, and fitted with appropriate footwear. Neuropathy can cause numbness, tingling or pain in the feet or legs. It develops gradually, usually in the feet. As it most often causes lack of protective sensation in the feet, skin injuries can occur without being perceived by the patient as painful and then become chronic wounds. If left untreated, these injuries can become serious wound problems for en estimated 15% of people with diabetes resulting in chronic infections, gangrene, and amputation. Physicians affiliated with the Curative Health Services' national network of Wound Care Centers(R), are using FootSense(TM), a pocket-size testing device that uses a flexible monofilament fiber to test nerve sensation in feet and legs. By checking for the feeling in patients' feet and legs regularly, physicians can determine if they have no present risk, impending risk or high risk of developing injuries or neuropathic ulcers. The medical staffs of Curative's Wound Care Centers also urge following some basic steps in proper foot care - ranging from wearing the right kind of socks to the way toe nails are trimmed - that are key in the prevention of amputations as a result of neuropathy: -- Never go barefoot either indoors or outdoors. -- If your feet become excessively dry, lubricate them with a thin film of moisturizing cream on the soles immediately after bathing. -- Avoid exposing feet to extremes. Never walk on hot sand or pavement. Protect feet from sunburn with sunscreen. Check bath water with elbow before entering; it should not be too hot. Do not use hot water bottles or a heating pad to warm cold feet; instead wear loose socks in bed if feet are cold. Never use hot or cold soaks for your feet. -- Nails should be trimmed straight across; gently round corners with a fine emery or pumice stone. -- Corns or calluses should not be cut; consult a physician or podiatrist for this type of care. Also do not use commercial corn or callus removers, foot pads or arch supports. -- Proper footwear is recommended. Only comfortable well fitting shoes should be worn. Do not choose shoes with open toes or heels, and do not wear sandals. -- Purchase new shoes late in the day when feet are slightly enlarged to assure they will fit comfortably at any time. New shoes should never be worn more than two hours at one time. -- No shoes should be worn more than five hours at one time. It is recommended that one pair be worn in the morning, one in the afternoon, and another for evening. -- Do not wear shoes without socks or stockings. Socks or stockings with seams should be avoided. Cotton and cotton blends are recommended. Socks should be clean and changed daily. -- Do not use garters or elastics to hold up stockings, and do not use panty girdles which are tight around the legs. If non-healing foot ulcers occur, consult with a physician. The Wound Care Center program considers a chronic non-healing wound to be one which has not demonstrated notable improvement after four weeks, or has not healed after a period of eight weeks. For more information about the comprehensive treatment at Wound Care Centers, call 800/991-HEAL (4325). Wound Care Centers is part of a nationwide network of treatment centers managed by Curative Health Services with headquarters in E. Setauket, N.Y. These more than 100 Wound Care Centers offer comprehensive, multi-disciplined wound management through individualized, aggressive treatment programs. AMPUTATION PREVENTION FACT SHEET -- November is National Diabetes Month and the educational focus for 1996 is the prevention of complications of diabetes, including amputation -- The American Diabetes Association estimates that diabetic-related amputation could be reduced by 50 percent if patients were routinely tested for neuropathy, educated to prevent injury or complications, and fitted with appropriate footwear as needed -- As many as half of the 16 million people with diabetes have or will develop neuropathy, or nerve damage, in their legs or feet that can lead to injuries, sores, chronic infections, gangrene or amputations -- Neuropathy is one of the most common complications of diabetes, resulting in the loss of protective sensation which signals pain and helps patients avoid injury -- An estimated 2.4 million people with diabetes will develop foot or leg ulcers -- Every year, an estimated 54,000 patients with diabetes have amputations as a result of complications from diabetes -- Patients with diabetes have a 15-fold increase in the risk of amputation over that of the general population -- Curative Health Services' nationwide network of more than 100 Wound Care Centers(R) has a comprehensive program that provides routine neuropathy testing and patient education to prevent non-healing wounds and amputation related to diabetes
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