Doctors are being urged to pay closer attention to people’s feet once they have recovered from an ulcer, a common diabetes complication.
Some estimates indicate one third of people with diabetes will suffer from a foot ulcer at some point during their life, but the complication can be avoided if people maintain good blood sugar control and regularly check their feet for any signs of damage.
Now, a research team from Arizona says diabetes healthcare teams should be turning their attentions to ulcer remissio, rather than recovery.
Lead author Dr David Armstong, professor of surgery and director of the Southern Arizona Limb Salvage Alliance at the University of Arizona College of Medicine, said: “This paper is the first of its kind to call attention to remission.
“The word ‘remission’ has been mentioned in the literature over the last few years. But this is the loudest call yet, and more than any other work before, (it) lays out data in a way that sort of flips the script from healing to what we do in between healed wounds.”
Figures suggest as many as 40 per cent of people who have had a foot ulcer will develop another one within the same year; that rises to 75 per cent within five years. It is because of the high recurrence rate that Armstrong thinks focusing on the person once they have been treated could help prevent another ulcer developing.
He said: “Diabetes can be more significant than many forms of cancer. This is a concept that’s misaligned right now in medicine. As we move toward diseases of decay, as I call them – things like cancer, cardiovascular disease, diabetes – our goal as physicians, surgeons, scientists and policymakers is to delay that decay.”
If left untreated, foot ulcers can become serious and in some cases lead to limb amputation. Those who do not develop an ulcer are 50 per cent more likely to live another 10 years, than someone who has been treated for one.
The findings were based on five billion outpatient visits. The researchers found the number of people being admitted to hospital with diabetic foot problems and ulcers were either comparable or exceeded patients with heart failure, kidney disease, depression or most types of cancer.
Dr Armstrong concluded: “The real idea here is for physicians to help people move through their world a little better and give them more ulcer-free days and more activity-rich days. We want to keep our patients moving, so they’re not on the sidelines of life.”
The study has been published in The New England Journal of Medicine.

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