Effectiveness of a comprehensive diabetes lower-extremity amputation prevention program in a predominantly low-income African-American population

OBJECTIVE - To compare patient outcomes 1 year before and 1 year after enro llment in a comprehensive diabetes lower-extremity amputation prevention pr ogram. RESEARCH DESIGN AND METHODS - Outcome data were obtained on 197 patients en rolled in the Louisiana State University Health Sciences Center Diabetes Fo ot Program, which provides foot care to a predominantly low-income African- American population in Louisiana. Data were obtained using a structured int erview administered by a registered nurse. Recordings were made of number o f days with an open foot ulcer, number of times hospitalized for a foot pro blem, number of days spent in thr hospital for a foot problem, number of vi sits to the emergency room for a foot problem, number of times an antibioti c was prescribed for a foot problem, number of all foot operations, number of lower-extremity amputations, and number of missed workdays for a foot pr oblem. Data were obtained on all patients at the initial visit and at the 1 -year follow-up. RESULTS - Analysis of data showed a reduction in foot-related ulcer days (- 49%), hospitalizations, (-89%), hospital days (-90%), emergency room visits (-81%), antibiotic prescriptions, (-57%), foot operations (-87%), lower-ex tremity amputations (-79%), and missed workdays (-70%) after 1 year of comp rehensive foot care compared with the 1-year period before treatment. CONCLUSIONS - This single cohort outcome study showed a large reduction in foot-related complications after the first year of comprehensive preventive foot care.