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Best Foot Forward: The Diabetes Foot Exam Case
This activity outlines how to conduct a comprehensive foot exam, clinical tests used to determine LOPS, plus offers recommendations and resources for patients with diabetes.

Best Foot Forward: The Diabetes Foot Exam Case

Anne Greenberg, BS; Mary P. Ettari, MPH, PA; Marie-Michèle Léger, PA-C; Anna E. Lindahl, RD, CDE, PA-C, MSHS; Erika M. Schwartz, DPM, FACFAS

Summary

While nearly 26 million children and adults in the United States have diabetes – approximately 7 million undiagnosed – another 79 million 20 years of age and older have pre-diabetes. Not only do individuals with the disease have to be concerned with treating their hyperglycemia , they also are at heightened risk of other diseases due to their diabetes. For example, adults with diabetes maintain a risk of stroke and heart disease mortality rate that are each 2 to 4 times higher than in those without diabetes. The disease accounts for 44% of all new cases of kidney failure and is the leading cause of new cases of blindness in adults younger than 75 years.

What’s more, anywhere from 60-70% of patients with diabetes suffer mild to severe forms of neuropathy and more than 60% of non-traumatic lower-limb amputations occur in people with diabetes, at a rate of about 180 each day. One of the first lines of defense against amputation: regular foot checks by the patient and an annual comprehensive exam by the clinician to ascertain the condition of the foot and any problems that have developed since the last exam. Equally important in guarding against amputation or less severe podiatric concerns is to educate patients on how to conduct daily self-exams of and care for their feet. 

Educational Objectives

Complete appropriate documentation for a comprehensive foot exam for patients with diabetes
Conduct a comprehensive foot exam for patients with diabetes
Differentiate among clinical tests conducted to determine loss of protective sensation (LOPS) in the feet of
     patients with diabetes

Provide recommendations and resources to patients that mitigate the risk of foot ulcers

Responsibility Statement

The American Academy of Physician Assistants takes responsibility for the content, quality, and scientific integrity of this CME activity.

Accreditation Statement

This activity has been reviewed and is approved for a maximum of 1.0 AAPA Category 1 CME credit by the Physician Assistant Review Panel. Participants should claim only those hours actually spent participating in the CME activity. This program was planned in accordance with the AAPA’s CME Standards for Enduring Material Programs and for Commercial Support of Enduring Material Programs. Approval is valid for one year from the issue date. Participants may submit the self-assessment at any time during that period. 
The American Academy of Physician Assistants takes responsibility for the content, quality, and scientific integrity of this CME activity.   

Disclosure Policy Statement

It is the policy of the American Academy of Physician Assistants to require the disclosure of the existence of any significant financial interest or any other relationship a faculty member has with the commercial interest of any commercial product discussed in an educational presentation. The participating faculty reported the following:

Anne Greenberg, BS
Medical Writer/Producer
Health and Medical Multimedia
Scottsdale, Arizona
No commercial relationships to disclose

Mary P. Ettari, MPH, PA
Physician Assistant
Volunteers in Medicine Clinic
Stuart, Florida
Consultant for Johnson & Johnson

Marie-Michèle Léger, PA-C
Director, Clinical Education
American Academy of Physician Assistants
Alexandria, Virginia
Employee for AAPA

Anna E. Lindahl, RD, CDE, PA-C, MSHS
Physician Assistant
Medical Specialties of Northern Virginia
Alexandria, Virginia
No commercial relationships to disclose

Erika M. Schwartz, DPM, FACFAS
Private Practice, Washington DC and Chevy Chase, MD
President, American Association for Women Podiatrists
No commercial relationships to disclose

Disclaimer

The opinions and comments expressed by faculty and other experts, whose input is included in this program, are their own. This enduring material is produced for educational purposes only. Please review complete prescribing information of specific drugs mentioned in this program including indications, contraindications, warnings, and adverse effects and dosage before administering to patients.

Supported by an educational grant from the Institute for Preventive Foot Health. 

Type:     Internet Activity (Enduring Material)
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