U.S. Department of Health and Human Services
Indian Health Service: The Federal Health Program for American Indians and Alaska Natives
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Friday, December 19, 2014

Division of Diabetes Treatment and Prevention - Leading the effort to treat and prevent diabetes in American Indians and Alaska Natives


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Evaluation and Interventions

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NOTE: Access to this information is not restricted; however, the information found here is intended for use by medical providers. Some videos contain graphic images. Patients should talk with their medical providers about any specific concerns.

Steps:

  • Conduct an annual foot exam
  • A normal exam indicates low risk for foot problems; focus on:
    • Self-management education
    • Control of blood sugar and blood pressure
    • Smoking cessation
    • Follow-up yearly
  • Abnormal exam indicates high risk for foot problems; focus on:
    • Self-management education
    • Protective shoes
    • Podiatry care
    • Plus measures for low-risk patients
    • Follow-up every 2-3 months
  • If an ulcer is detected at the visit, determine if it is an uncomplicated or complicated ulcer:
    • Uncomplicated ulcers
      • 2 cm, no deep tissue involved, no major infection, adequate circulation
      • Outpatient care with weekly debridement, daily dressing changes, off-loading, oral antibiotics if limited infection
      • Weekly follow-up
    • Complicated wounds
      • >2 cm, involve deep tissue, major infection, inadequate circulation
      • Hospital Care with surgical debridement, dressing changes, vascular assessment, IV antibiotics with treatment directed by culture
      • Follow-up daily until infection controlled, circulation resorted and/or ulcer size reduced
      • Then follow as uncomplicated ulcer

 

Overview How To Other Resources

Division of Diabetes Treatment and Prevention | Phone: (505) 248-4182 | Fax: (505) 248-4188 | diabetesprogram@ihs.gov