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At least 73 records · Page 4Linked to original sources
PubMed1997

Guidelines on the care of diabetic nephropathy, retinopathy and foot disease.

Diabetes mellitus is a common disease frequently managed by family physicians. Because of its high prevalence and associated comorbidity, diabetes mellitus has received a great deal of attention from several specialty organizations. The American Diabetes Association, the American Board of Family Practice and the Centers for Disease Control and Prevention have published specific practice guidelines and recommendations for the care of diabetic patients. These recommendations include annual comprehensive foot examinations, yearly ophthalmologic screening for retinopathy, and urinalysis for microalbuminuria. The use of angiotensin converting enzyme inhibitors is advocated for the majority of diabetic patients with proteinuria or hypertension. Based on recent evidence, improved glycemic control is also increasingly advocated. Compliance with practice guidelines by primary care physicians has historically been poor. Mechanisms such as the use of patient problem lists and diabetic flow sheets can serve as reminders to physicians and can facilitate closer adherence to practice guidelines.

Diabetes Mellitus↗
PubMed1994

Assessment and management of foot disease in patients with diabetes.

Limb- or life-threatening complications in patients with diabetes can be prevented with an integrated, multidisciplinary approach. Most patients seen in clinical practice are in the early stages of the disease process. Glycemic control retards the progression of neuropathy, which is the most important risk factor for ulceration. Early detection of the loss of protective sensation and implementation of strategies to prevent ulceration will reduce the rates of limb-threatening complications. Clinicians should routinely examine the feet of diabetic patients. Education in foot care, proper footwear, and close follow-up are required to prevent or promptly detect neuropathic injury. If ulceration occurs, removal of pressure from the site of the ulcer and careful management of the wound will allow healing in most cases. The failure to heal despite these measures should prompt a search for associated arterial insufficiency. If infection is present, appropriate antimicrobial therapy combined with immediate surgical intervention, including revascularization when necessary, will increase the chances of saving the limb. With this comprehensive approach, it is possible to achieve the goal of a 40 percent decrease in amputation rates among diabetic patients by the year 2000.

Anti-Bacterial Agents↗
PubMed1997

An overview of foot disease associated with diabetes mellitus.

The pathologic mechanisms by which diabetes creates alterations in the neural, vascular, and immunologic systems are complex. Thanks to increased knowledge, clinicians can intercede and prevent disease and disability. Appropriate glycemic control for all patients with diabetes can prevent neuropathy and vascular changes. Early detection and appropriate intervention for patients at risk for ulceration must be a part of every nurse's practice. Education of the patient or significant other must be included as part of instruction provided to those with diabetes. In contrast to the devastating results of the pathology of diabetes, these interventions seem "painfully" simple.

Diabetic Foot↗