Assessment and Management of Foot Disease in Patients with Diabetes

The human and financial costs of lower-extremity amputation in patients with diabetes mellitus are well recognized 1 . However, the rates of major amputation in the United States remain high, 2 in part because present knowledge regarding the prevention and management of foot disease is not widely applied in clinical practice. The U.S. Department of Health has set a goal for the year 2000 of a 40 percent reduction in amputation rates among diabetic patients 3 . Methods to achieve this goal are available today. For example, in the majority of diabetic patients, the initial condition that eventually leads to amputation is a . . .