A Deep Look at Diabetic Foot Ulcers, Amputation Risks, and Patient Care

In this episode of MD Newsline, Dr. Alyson K. Myers, endocrinologist and Associate Chair for Faculty Mentoring and Community Engagement at Montefiore in the Bronx, dives into one of the most pressing and underrecognized complications of diabetes: diabetic foot ulcers (DFUs) and the devastating risk of amputations. She discusses the intersection of clinical care, social determinants of health, and healthcare disparities, while also highlighting emerging technologies and multidisciplinary clinic models designed to reduce risks and improve patient outcomes. Drawing on her extensive experience in diabetes management and community engagement, Dr. Myers emphasizes both the urgent need for systemic change and the practical tools clinicians can use today to protect their patients.Episode Highlights

High Amputation Risk in Diabetic Foot Ulcers Dr. Myers shares sobering statistics, noting that 44% of patients who present with a diabetic foot ulcer undergo an amputation within five years. This reality highlights the urgency of early screening, prevention, and intervention in diabetes care. She stresses that DFUs are not only medical complications but also markers of systemic inequity and missed opportunities for prevention.

The Role of Social Determinants of Health Dr. Myers explores how socioeconomic status, racial disparities, and provider bias profoundly shape patient outcomes. In the Bronx and other underserved areas, patients often face delays in diagnosis, limited access to care, and inconsistent follow-up, all of which contribute to worse outcomes. She emphasizes the importance of addressing these systemic barriers alongside clinical treatment.

Innovative Technology for Prevention Emerging tools, such as thermal-sensing mats and sensor-equipped socks, offer promising ways to identify foot ulcers before they progress. These devices can detect subtle temperature changes that indicate early tissue damage, allowing patients and providers to intervene earlier. Dr. Myers highlights the potential of technology to improve adherence and reduce disparities by making self-care more accessible.

Building Multidisciplinary DFU Clinics Dr. Myers describes the creation of a multidisciplinary DFU clinic in the Bronx, modeled after programs at institutions like Stanford. By integrating endocrinology, podiatry, vascular surgery, infectious disease, and behavioral health, this model ensures that patients receive comprehensive, coordinated care. She explains how this approach can drastically reduce amputation rates and improve long-term patient outcomes.

Patient and Caregiver Education Education remains a cornerstone of DFU prevention. Dr. Myers emphasizes strategies such as ensuring patients wear proper footwear, involving caregivers and family members in diabetes care, and simplifying self-care routines. She points out that community-based education and culturally sensitive approaches are essential for building trust and improving adherence.

Advocacy and Policy Change Beyond clinical care, Dr. Myers stresses the importance of advocacy and systemic reform. She calls for insurance coverage expansion for proven therapies, including GLP-1 receptor agonists and PAD (peripheral arterial disease) screenings, which can significantly improve outcomes. Her message is clear: reducing disparities in diabetes care requires action at every level—from the exam room to healthcare policy.

Key Takeaway

Diabetic foot ulcers are a leading cause of amputation, yet they remain preventable with the right tools and care models. Through early detection technologies, multidisciplinary clinics, culturally sensitive education, and equitable access to therapies, healthcare providers can dramatically improve patient outcomes and close persistent gaps in diabetes care.

Resources

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Connect with Dr. Alyson K. Myers:LinkedIn

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