Diabetic Foot Update to examine major consensus statement

San Antonio (Dec. 10, 2003) – The 19th Annual “Diabetic Foot Update: A Multidisciplinary Approach” will be held Dec. 11-14 at the Rivercenter Marriott Hotel, 101 Bowie St. in downtown San Antonio. Larry Harkless, DPM; John Steinberg, DPM; and Richard Adam, DPM, all from the department of orthopedics at The University of Texas Health Science Center at San Antonio, are the conference coordinators.

This year’s event includes presentation and discussion of new American Diabetes Association Consensus Development Panel guidelines for managing peripheral arterial disease (PAD) in diabetes. PAD refers to arterial disease that affects the feet and hands.

“The Diabetes Association convened a consensus development conference in May 2003 on this issue, and the consensus statement was published in the December issue of Diabetes Care,” Dr. Harkless said. “One of the major recommendations is that PAD is a marker for death and should be managed very aggressively. Another consensus is that PAD is a marker for circulation all over the body. If it is occurring in extremities, it is also occurring in the heart, vasculature, eyes and other parts of the body.”

The consensus guidelines point out the value of the ankle/ brachial index, a non-invasive vascular test that compares blood pressure registered in the brachial artery of the arm with blood pressure registered in the ankle. “This tells a physician whether you have blood flow issues or not,” Dr. Harkless said. “It is a simple way to screen for circulatory disease. By finding a discrepancy early and encouraging behavior modification related to diet, exercise and cessation of smoking, we can prevent outcomes such as foot amputation.”

Diabetic patients should ask their primary care physicians about the ankle/brachial index during visits, Dr. Harkless said. The state of Texas no longer provides Medicaid reimbursement for podiatrists to do this and similar preventive measures.

According to the new consensus guidelines, an ankle/brachial index should be considered in diabetic patients less than 50 years of age who have other PAD risk factors such as smoking, hypertension, high cholesterol, or a history of diabetes longer than 10 years. It should be done in all diabetic patients over 50, the guidelines indicate.

Note to media: Friday, Dec. 12, is devoted to the consensus recommendations and Dr. Harkless will lead these sessions. Mellick T. Sykes, M.D., a San Antonio vascular surgeon and clinical faculty member in the department of surgery at the Health Science Center, will also be available to talk about the consensus recommendations. Dr. Sykes was a member of the consensus panel. For a schedule of presentations and other conference information, click on http://www.diabeticfoot.org.

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