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Early Intervention Essential To Management Of Diabetes

Health care professionals need to take control of diabetes management now to prevent a global pandemic from spreading, according to Katia Langton, DC, CPed.

Langton, a former chiropractor who works as a pedorthist at Island Pedorthic Foot Care in Vancouver Island, Canada, spoke at the Pedorthic Footcare Association and American Podiatric Medical Association Combined Meeting.

Diabetes contributes to the death of approximately 4 million people each year and costs billions of dollars each year to treat, and the numbers continue to grow, Langton said. If diabetes were a country, it would be the third-largest in population size, coming after China and India but before the United States, she said.

“The number of diabetic patients globally is increasing at a staggering rate,” Langton said.

Early intervention is key to diabetes treatment, according to Langton.

“If we do not treat this disease differently, earlier in the progression … to keep the patients on the ground walking and mobile so they can manage their blood sugar and prevent complications, we are going to have a really big problem,” Langton said. “What we need to do is get ahead of [diabetes], because we will not have the resources to treat these ulcers and amputations with the staggering numbers coming in globally.”

Langton’s clinic offers a host of services for diabetic patients, including diabetic foot assessments, wound assessments, education on peripheral neuropathy, comprehensive foot exams and preventive foot care. But often, patients are sent in too late.

“Our allied health care professionals that were sending us patients were not sending them early enough. So, we talk to different groups — health care professionals [and] the general public,” Langton said. “It is really important that we talk to all our other health care professionals about treating this disease earlier.”

Langton said organizational change is needed in order to get diabetes under control.

“A lot of health care professionals do not quite understand the progression of the diabetic foot,” she said.

According to Langton, patients progress from a diagnosis of diabetes to an insensate foot, and then to limited joint mobility, peripheral vascular disease, ulcerations, Charcot foot, amputation and finally, death. Because 50% of patients who have undergone a diabetes-related amputation will die within 3 years, and approximately 1 million diabetes-related amputations are performed annually, the disease needs to be stopped before it progresses to that level, she said.

“We need to reframe the way that we are treating diabetic foot. If we can start at ground zero, teaching everybody around us the progression of the diabetic foot … if we can start front-end-loading our education and our resources and seeing these patients early, we have a chance to fight this disease and keep them walking and mobile,” Langton said.

Langton advised practitioners to take the urgency of diabetes back to their communities and move in the direction of treating this patient population earlier.

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