Elizabeth Custik
Stony Brook University School of Medicine, USA
Title: Public health intervention to address the burden of dermatological complications of diabetes-related foot disorder in community-dwellers living in rural Ecuador
Biography
Biography: Elizabeth Custik
Abstract
Diabetes-related foot disorders (DRFD) are among the most feared complications of diabetes mellitus. Foot and ankle ulcerations are the most common causes of non-traumatic amputations in the world. As the majority of these amputations are preventable, efforts should be directed to early detection of individuals at risk, particularly in underserved populations where people are often uninformed of the tremendous risks posed by ulcerative lesions in the feet and ankles. A population-based cohort study to assess the burden of DRFD dermatological sequale was conducted in Atahualpa, a rural Ecuadorian village, by identifying residents aged ≥40 years with diabetes mellitus using ankle brachial index to determine presence of peripheral arterial disease, foot examination to assess skin changes, dry skin, ulcerations, fissures and the Michigan Neuropathy Screening Instrument to estimate peripheral neuropathy. Ulcers of the foot/ankle and amputations (always preceded by ulcers) were noticed in 7% of participants and 60% of individuals without ulcers or amputations were at moderate to high risk of developing active diabetic foot disease. These ulcers had been previously recognized and treated in less than 20% of patients. Public health strategies directed to reduce the incidence of catastrophic consequences such as lower limb amputations, are urgently needed to improve the quality of life of millions of persons with diabetes mellitus living in these underserved populations. As a result, weekly community health workshops have been implemented in Atahualpa to educate the high-risk population about the prevention, recognition and care for dermatological manifestations of DRFD to prevent amputation.