Preventing amputations from diabetes mellitus: the Indian Health Service experience
West Indian med. j
;
50(supl.1): 41-43, Mar. 1-4, 2001.
Article
in English
| LILACS
| ID: lil-473085
ABSTRACT
With the heavy burden of diabetes mellitus among American Indians and Alaskan Natives, lower-extremity amputation (LEA) has become a common complication. Rates of diabetes-related LEA are 2-3 times those observed in other diabetic populations. During the past 12 years, the Indian Health Service (IHS) has made LEA prevention a public health priority. From 1988 to 1992 screening criteria based on simple examinations were developed and validated in primary care Settings. Prevention efforts have focused on targeting high-risk individuals for self-care foot education, provision of protective footwear, and routine podiatry care. Follow-up studies in Alaska and northern Minnesota saw 25-50reductions in LEA rates associated with these interventions. In settings where these efforts were augmented with system changes, such as team coordination, patient-tracking systems, comprehensive footcare practice guidelines, flowsheets, and outreach programmes, LEA incidence was reduced by 50-75. Efforts are currently underway to disseminate system-based approaches for comprehensive diabetic footcare and to expand the availability of foot care resources to tribal communities served by the IHS.
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Index:
LILACS (Americas)
Main subject:
Indians, North American
/
Diabetic Foot
/
Amputation, Surgical
Type of study:
Etiology study
/
Practice guideline
/
Incidence study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Humans
Country/Region as subject:
North America
Language:
English
Journal:
West Indian med. j
Journal subject:
Medicine
Year:
2001
Type:
Article
/
Congress and conference
Affiliation country:
United States
Institution/Affiliation country:
Bemidji Area Indian Health Service/US
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