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Pulse Home Health Care practices skilled health care procedures firmly rooted in the latest research and best practice policies. We routinely mail bulletins to physicians and other medical referral sources to highlight how we help patients and to explain the scientific basis for different services. On our home health website we share selected physician bulletins about Pulse's Home Health Services. If you have questions about how home health could help you, please contact us today.

Diabetic Foot Ulcers

Independently Linked to Increased Mortality


Diabetic Foot UlcersAt the 20th World Diabetes Congress, Marjolein Iversen presented findings that independently linked diabetic foot ulcers to a 229% increase in mortality rates.(1) For ten years, Bergsen and colleagues performed a large, population-based study following 65,126 people.  For diabetic subjects with a history of foot ulcers, they measured a ten-year mortality rate of 49%.  This was much higher than the mortality rates for diabetics without foot ulcers (35.2%) and subjects without diabetes (10.5%).  In the past, authors have suggested that diabetic foot ulcers serve as a marker of other, unknown, disease processes that lead to increased mortality rates. (2)  Moulik et al. state that diabetic foot ulcers and their complications cause morbidity and mortality. (3)  Iversen’s recent report and Moulik’s 2003 publication found that diabetic foot ulcers were associated with significantly increased mortality risk even after adjusting for factors such as age, life-style, cardiovascular disease, nephropathy, neuropathy, and other comorbidities. (3)  This risk adjusted association suggests that diabetic foot ulcers may have a causal role in the dramatically increased mortality risk and/or that diabetic foot ulcers signal higher risk disease processes that merit increased caution.

Diabetic foot ulcers serve as one of many signs that patients may have a skilled need for disease management teaching.  Other possible triggers for a skilled teaching referral include newly diagnosed diabetes, uncontrolled blood glucose levels, or uncontrolled blood pressure levels. 

In cases of diabetic foot ulcers, Pulse Home Health Care nurses can provide professional wound care, teach patient and family about wound care, verify productive adherence to wound care instructions, and monitor for fast response to worsening wound conditions.  Moreover, in all cases of diabetes management services, Pulse Home Health Care nurses can investigate compliance with special diets, assess use of home equipment, assess medication compliance, and consult on exercise intervention for better diabetes management.  With access to your patients’ pantries and medicine cabinets and with the ability to make multiple visits over multiple weeks for follow-up, our home health nurses are ideally positioned to identify misunderstandings and coach patients for optimal diabetes management.  

References

  1. Iversen M, Ostbye T, Tell G, et al. History of foot ulcer increases mortality among individuals with diabetes. Diabetes Care. December 2009; 32 (12): 2193-2199.
  2. Boyko E, Ahroni J, Smith D, et al. Increased mortality associated with diabetic foot ulcer. Diabet Med 13; 1996: 967-972.3. Moulik P, Mtonga R, Gill G. Amputation and mortality in new-onset diabetic foot ulcers stratified by etiology. Diabetes Care, 2003; 26: 491-494

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HomeCare Elite
2009     2010
Named as one of the top 500 agencies nationwide

2325 Severn Ave, Ste 5 Pulse Home Health CareMetairie LA 70001 Pulse Home Health Care(504) 831-7778

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