Make Amputation Prevention a Priority in #Diabetes


Make preventive care a priority

By Ronald Jensen


Over the course of their career, medical professionals often make decisions that permanently affect the lives of their patients. For me, as a doctor of podiatric medicine, nothing is more tragic than sitting down with a patient to inform them that he or she will have no other choice than to have a toe, a foot or even their entire leg amputated due to blood flow complications from diabetes. The most frustrating part? This situation is one that typically could have been prevented—time and time again.

Amidst the wrangling over an agreeable healthcare reform solution, Americans are still trying to come to terms with reform’s hefty price tag. For many, it is hard to imagine increasing funding for a healthcare system that has already proven to waste millions of dollars each year.

It has been widely publicized in the media that the U.S. spends more than twice on healthcare what other developed countries do—yet sees little return on this enormous investment. Lost in the media mix and debate of the issues is a fundamental principle that is not brought to the forefront of discussion often enough: prevention.

As president of the American Podiatric Medical Association, I believe that access to preventive care outweighs the effectiveness of some of medical technology’s greatest triumphs. Daily, my colleagues and I are on the front lines of diabetes management. Without the doctors to catch a person’s blood flow problems to their lower limbs before the onset of serious complications, even the most advanced technologies are of little use to successfully treat the condition.

Make no mistake, providing better preventive care for epidemics such as diabetes could help save our broken healthcare system billions of dollars every year. Diabetes is not only devastating to the entire body—it also hits the American healthcare system hard in the wallet, with direct and indirect costs reaching nearly $200 billion per year.

Nearly 24 million people—8% of the U.S. population—are currently battling diabetes. Treating the disease and its many complications requires a complete management team, including a podiatric physician, to attend to the necessary foot care those with diabetes require. However, diabetic complications are frequently seen by a medical professional only after the sole treatment option is total amputation of a toe, foot or lower limb.

Many of our nation’s healthcare problems have evolved from a general lack of education. Studies have shown that simply creating greater public awareness of diabetic foot care could positively affect our healthcare system. According to an article published in the Journal of the American Podiatric Medical Association, comprehensive amputation prevention programs can reduce amputation rates from diabetic complications by as much as 70%.

Detecting diabetic foot ulcers early and staving off tragic foot and leg amputations benefits more than just the individual whose foot or leg is spared. The entirety of amputation costs avoided with prevention—including actual procedural costs, necessary hospital stay and follow-up care—can save our healthcare system up to $8 billion each year. Complications from diabetes—including diabetic ulcers and amputations—are preventable, but only with the help of a diabetes management team, which includes a podiatrist, vascular surgeon and primary-care physician.

Diagnosed cases of diabetes will continue to rise exponentially without an immediate intervention. Current statistics show that nearly 6 million Americans have diabetes and are not aware of their disease.

Something must be done to encourage both those with diabetes and those at risk to seek out the critical preventive care that will save their limbs and their life. I urge our lawmakers to make diabetes prevention—and preventive care for all major health conditions—a top-level priority in the healthcare reform debate. The short-term payoff may not be seen overnight. The long-term successes, however, will be monumental—helping to keep doctors like myself from having to present patients with a heart-breaking, life-altering diagnosis far too often.

Ronald Jensen, a physician, is president of the American Podiatric Medical Association. He resides and practices podiatry in Modesto, Calif.

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