Diabetes and the Diabetic Foot
Dr Feld and our staff take a friendly, thorough and gentle approach in caring for our patients. We attempt to fully educate you about your foot problems and treatment options and make every effort to ensure you understand the conservative treatments which may be available including heat moldable and custom shoe inserts as well as the all important toe filler for individuals with a history of a toe amputation.
We have many styles and sizes of diabetic shoes available including those hard to find sizes and widths.
We hold a wide range of shoes in stock to enable you to try on and test whilst in the office.
Each day approximately 2,200 people are diagnosed with diabetes. There are 798,000 new cases of diabetes diagnosed each year.
Total number: 15.7 million people in the United States which represents 5.9% of the population.
Diagnosed: 10.3 million people
Undiagnosed: 5.4 million people
Diabetes is the seventh leading cause of death (sixth-leading cause of death by disease) in the United States.
Diabetes Prevalence by age
- Age 65 years or older: 6.3 million, 18.4 percent of all people in this age group have diabetes
- Age 20 years or older: 15.6 million, 8.2 percent of all people in this age group have diabetes
- Under age 20: 123,000, 0.16 percent of all people in this age group have diabetes
Diabetes Prevalence by sex
In people 20 years or older:
- Men: 7.5 million or 8.2 percent of all men have diabetes
- Women: 8.1 million or 8.2 percent of all women have diabetes
Diabetes Prevalence by race/ethnicity:
In people 20 years or older:
Non-Hispanic Whites: 11.3 million or 7.8 percent of all non-Hispanic whites have diabetes
African Americans: 2.3 million or 10.8 percent of all African Americans have diabetes, however, one-third of them do not know it. African Americans are 1.7 times more likely to have diabetes, than non-Hispanic whites of similar age. Twenty-five percent of African Americans between the ages of 65 and 74 have diabetes. One in four African American women over 55 years of age has diabetes. African Americans experience higher rates of amputation than Hispanic or white Americans with diabetes. They are 1.5 to 2.5 times more likely to suffer from lower limb amputations.
Hispanic/Latino Americans: 1.2 million or 10.6 percent of Mexican Americans have diabetes. Approximately 24 percent of Mexican Americans, 26 percent of Puerto Ricans, and 16 percent of Cuban Americans between the ages of 45 and 74 have diabetes.
Mexican Americans are 1.9 times as likely to have diabetes as non-Hispanic whites of similar age. Hispanic/Latino Americans are almost twice as likely to have diabetes as non-Hispanic whites of similar age.
American Indians and Alaska Natives: 9 percent of American Indians and Alaska Natives have diagnosed diabetes. On average, American Indians and Alaska Natives are 2.8 times as likely to have diagnosed diabetes as non-Hispanic whites of a similar age.
Complications of Diabetes Nerve Disease
About 60-70 percent of people with diabetes have mild to severe forms of diabetic nerve damage (which often includes impaired sensation or pain in the feet or hands, slowed digestion of food in the stomach, etc.) Severe forms of diabetic nerve damage can lead to lower extremity amputations.
Ulcers and Amputation
During their lifetime, 15 percent of people with diabetes will experience a foot ulcer and between 14 and 24 percent of those with a foot ulcer will require amputation. Diabetes is the leading cause of lower extremity amputations in the United States occurring among people with diabetes. Each year, more than 86,000 amputations are performed among people with diabetes.
After an amputation, the chance of another amputation within 3 to 5 years is as high as 50 percent. The 5 year mortality rate after amputation ranges from 39 to 68 percent.
Heart Disease and Stroke
People with diabetes are 2 to 4 times more likely to have heart disease which is present in 75 percent of diabetes-related deaths. The risk of stroke is 2 to 4 times higher in people with diabetes.
Diabetes is the leading cause of new cases of end-stage renal disease, accounting for about 40 percent of new cases.
Diabetes is the leading cause of new cases of blindness in adults 20 to 74 years of age. Each year 12,000 to 24,000 people lose their sight because of diabetes.
Cost of Diabetes
The total annual cost for the more than 86,000 amputations is over $1.1 billion dollars. This cost does not include surgeons’ fees, rehabilitation costs, prostheses, time lost from work, and disability payments.
Foot disease is the most common complication of diabetes leading to hospitalization. In 1996, foot disease accounted for 6 percent of hospital discharges listing diabetes and lower extremity ulcers, and in 1996, the average hospital stay was 13.7 days. The average hospital reimbursement from Medicare for a lower extremity amputation was $13,512 and from private insurers $26,126. At the same time, rehabilitation was reimbursed at a rate of $7,000 to $21,000.
Diabetes and Medicare
6.3 million of the 38 million people enrolled in the Medicare program have diabetes.
Medicare provides coverage for therapeutic footwear such as, depth-inlay shoes, custom-molded shoes, and shoe inserts for people with diabetes who qualify under Medicare Part B.
Prevention and Treatment of Diabetes
Foot Problems According to the National Diabetes Education Program (NDEP), a partnership among the National Institutes of Health, the Centers for Disease Control and Prevention and over 200 organizations, including the American Podiatric Medical Association, as many as half of the lower extremity amputations might be prevented through simple but effective foot care practices. These practices include:
- Early identification of the high risk diabetic foot
- Early diagnosis of foot problems
- Early intervention to prevent further deterioration that may lead to amputation
- Patient education for proper care of the foot and footwear
American Diabetes Association: (http://www.diabetes.org/) Diabetes Facts and Figures, 2000
Feet Can Last A Lifetime: National Diabetes Education Program A joint program of the National Institutes of Health and the Centers for Disease Control and Prevention, 2000
Centers for Disease Control and Prevention (http://www.cdc.gov/) National Center for Health Statistics
American Association of Diabetes Educators (http://www.aadenet.org)
Wound Healing Society (http://www.woundheal.org/)
Podiatry Care for the Entire Family
Dr. Feld is one of the best medical providers I have seen. He cured my poor little foot and now I walk around pain free. Thank you so much for helping me and working with my crazy schedule!
Caring, honest and has lots of knowledge. I was very satisfied with the care Doctor Feld provided and the surgery which was performed on my hammer toe. I will return and get the other toe worked on (once the summer is over.)
I have been coming to see Dr. Feld and his staff for many years. Every time I walk into the office I am greeted with a cheerful smile and "Hello" from the staff members and never wait more than 5 minutes before I am brought back to be seen. They work around my schedule and answer any questions I may have. I highly recommend!!