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Identifying diabetic patients at high risk for amputation.
L Umeh1, M Wallhagen, N Nicoloff
1Continuing Care Services Dept., Kaiser Permanente Medical Center, Richmond, Calif., USA.
The Nurse Practitioner
|September 9, 1999
Summary
Diabetic foot amputations, often caused by neuropathy, are preventable. Healthcare providers can identify at-risk patients using a Semmes-Weinstein monofilament and implement preventive measures to avoid lower-extremity amputation.
Area of Science:
- Podiatry
- Endocrinology
- Diabetology
Background:
- Lower-extremity amputation is a serious complication of diabetes mellitus.
- Up to 50% of diabetic amputations are preventable.
- Diabetic peripheral neuropathy is a primary cause in 82% of cases.
Purpose of the Study:
- To review methods for identifying high-risk diabetes patients for lower-extremity amputation.
- To discuss preventive interventions for diabetic foot complications.
Main Methods:
- Utilizing the Semmes-Weinstein monofilament to detect protective sensation loss.
- Referring patients with a history of foot deformity, ulceration, or prior amputation for specialized footwear or orthotics.
Main Results:
- Early identification of protective sensation loss is crucial.
- Proactive measures can prevent foot ulceration and subsequent amputation.
- Specialized footwear and orthotics are recommended for high-risk individuals.
Conclusions:
- Healthcare providers play a vital role in preventing diabetic lower-extremity amputations.
- Screening for neuropathy and implementing preventive strategies are key.
- Patient education alone is insufficient; clinical assessment and intervention are necessary.