ESCANABA — Once again, Diabetes Awareness Month came and went. But little has changed in how we go about preventing the debilitating consequences to the feet. Certainly, as many are aware, diabetes mellitus is associated with multiple complications, from heart disease to vision problems, clogged arteries and kidney disease. But not enough attention is given to the problem of “diabetic foot disease.”

We are referring to the high rate of foot ulcerations, infections, and amputations that occur to these individuals. It is true we have made great strides in how many of these infections we can resolve and ulcers we are able to heal. But the statistics are very clear, when someone with diabetes has their 1st foot ulcer, they become significantly more susceptible to further ulcerations. Additionally, the longer an ulcer is open, the greater the risk of infection, translating to more frequent hospitalization and amputation.

Another startling number is the mortality rate of a diabetic amputee. When a diabetic suffers a major amputation (a foot or leg), most don’t live another three years. Thus, when we are able to prevent a major amputation, we not only save a limb, we also save a life. But prevention of a diabetic foot ulcer is a better approach on multiple levels. Skin provides a wonderful barrier to infection, but an opening of some kind allows bacterial invasion. And diabetic infections can spread rapidly.

Perhaps the most glaring number is how many of these amputations didn’t need to happen. Experts claim 85% of the major diabetic amputations performed were preventable. The key is preventing the initial skin breakdown, regardless of the cause, either from a tight shoe or a minor skin injury. The latter is often self-induced, the result of someone with diabetes trimming their abnormal toenails. These individuals can develop a serious foot problem and have no pain, the result of the nerve disease (neuropathy), which occurs to most.

It is possible to reduce the number of these skin injuries. This does not require some advanced technology: simply being educated in best home foot care practices leads to a marked reduction in these complications. When people with diabetes are taught all the various components of diabetic home care, less ulcers and infections occur. The most common reason someone with diabetes is admitted to the hospital is a foot infection. But proper diabetic foot care, a result of directed education, generally minimizes the likelihood this admission is necessary.

As a society, we have failed to provide the appropriate education shown to reduce these consequences. Simply put, we need to teach these people and their families how to take care of their feet. Until a dedicated program is instituted nationally for this, their best opportunity is to consult with a foot specialist dedicated to this educational effort. We can reduce the number of limbs and lives lost to diabetes. Prevention should be the goal, and education is the key.

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Dr. Conway McLean is a physician practicing foot and ankle medicine in the Upper Peninsula, with offices in Escanaba, Marquette, and L’Anse. McLean has lectured internationally on wound care and surgery, being board certified in surgery, orthotic therapy and wound care. His articles on health and wellness appear in multiple local and national publications. Dr. McLean welcomes subject requests for future articles at drcmclean@outlook.com.