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June 15, 2009Loss of feeling in the feet is a common complication of diabetes, so it's critical that those with the disease wear shoes that fit properly and check their feet often for cuts or sores. Left untreated, a diabetic's foot wound can lead to a serious infection or even require amputation.
With diabetes rates steadily increasing, the issue is emerging as a major public health problem. At Temple's School of Podiatric Medicine, doctors have long stressed to their patients the need to check their feet and shoes, even if they can't feel pain. But that's not always enough.
"The fundamental challenge for doctors is that many diabetic patients lose the ability to feel pain and therefore fail to appreciate the urgency of daily foot care," said Jinsup Song, director of the school's Gait Study Center and assistant professor of podiatric medicine and orthopedics. "Many of our diabetic patients don't understand simple foot care instructions and fail to perform even basic preventive measures, such as inspecting their feet daily or wearing protective shoes."
Song is ready to meet this challenge head on. Armed with a four-year grant from the National Institutes of Health totaling up to $650,000, he and other researchers at Temple will test the effectiveness of a personalized, visual diabetic foot education strategy developed using information collected at the Gait Study Center.
"Existing research shows that in underserved minority communities such as the ones serviced by Temple health literacy is a major challenge," said Song. "That tells us that diabetic foot care education needs an improvement."
Song feels that giving patients a list of do's and don'ts simply isn't enough; he and his team hope that personalized education programs that show where injuries can occur and how to prevent them will help reduce the number of foot complications associated with diabetes.
Currently, more than 8 percent of the U.S. population has diabetes; a report from the NIH and the Centers for Disease Control and Prevention finds that another 30 percent have prediabetes — higher than normal blood sugar levels that could lead to type 2 diabetes. Health officials worry that these numbers portend a surge in type 2 diabetes — which, among other things, could mean an increase in foot problems.
"Giving our patients the proper education on their condition can help empower them to make better decisions about their foot care," said Song. "Not only does that help cut down on medical costs, it can reduce instances of chronic wounds and amputations, and help maintain a good quality of life for our patients."
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