User:Seshore012755

= = Diabetic Foot Care= = In order to reduce the ibncidence of infection and amputation, daily monitoring of the foot is essential for diabetics There are over sixteen million people with diabetes in the United States.  Fifteen percent of these patients will develop foot ulcers during their lifetime.  Diabetic foot ulcers significantly increase morbidity and mortality rates due to infections and complications associated with these ulcers. Approximately 67,000 amputations occurred between 1993 and 1995 on patients with diabetes.  Over 50% of these patients will require a subsequent amputation three to five years after the first amputation. Due to decreased sensation of the diabetic foot, diabetic patients must be taught to perform daily self checks of their feet. A mirror can be used to visualize hart to reach areas. Patients with visual impairments must have a caregiver perform these daily checks. It is recommended that non-scented lotion be applied to the feet daily to minimize dryness. It is also the responsibility of the patient to have regular visits to a podiatrist for foot inspection and nail clipping. In addition to daily foot checks, patients must be taught to minimize unnecessary pressure on the feet. It is essential that socks and shoes fit appropriately. The Medicare supported Therapeutic Shoe Bill pays for special footwear and insoles. This includes one pair of custom-molded shoes, two additional pairs of insoles, plus one pair of over-the-counter extra-depth shoes plus three insoles yearly. Physicians and medical personnel should inspect the diabetic foot periodically. It is recommended that yearly checks with an inexpensive monofilament be performed by healthcare personnel. Patients are at greater risk for developing ulcers when the degree of neuropathy is greater. There are also more costly tests that can be performed to determine foot vascularity. When an ulcer is detected, patients must see a doctor who can begin immediate treatment. Ulcers should be measured upon initial examination and thereafter. Length, width, and depth should be documented. Studies may be done to rule out osteomyelitis. The area surrounding the ulcer should also be inspected. While an ulcer is healing, care should be taken to prevent any infection from entering the ulcer. Dressings should be adequate to promote healing and prevent the entry of any bacteria. With all advanced care and treatment that physicians and healthcare workers provide, nothing is more important than daily self examinations.