Diabetes-related Amputations: A Pandemic within a Pandemic

The COVID-19 pandemic has resulted in millions of infections and more than one million deaths worldwide, but the toll of indirect effects of the pandemic are now being discovered.
There have been an estimated 100,000 excess deaths in the United States since February 1, 2020. Excess deaths are those unrelated to COVID-19 but that are higher than the predicted number of deaths from all other causes. The World Health Organization surveyed 155 countries during May 2020 and found half of the countries had partially or completely disrupted services for diabetes and diabetes-related complications and warned of the pandemicಬs global impact on noncommunicable diseases.

In June 2020, an editorial in the New England Journal of Medicine (NEJM) spoke of the “Untold toll [of the] pandemicಬs effects on patients without COVID-19.” Now 4 months later, that toll is no longer untold especially for patients with lower-extremity complications of diabetes.

Early in the pandemic, The Alliance of Wound Care Stakeholders advised hospitals, policymakers, and governments not to close wound centers or delay necessary care to wound patients because it would result in an increase in infections, hospital admissions, ER visits, and amputations.

In “A Tale of Two Cities,” Shin et al described the approaches to the diabetic foot at centers of excellence in Los Angeles and Manchester, England. Both centers used telemedicine to reduce in-person contact with the health system, but the authors cautioned not to avoid necessary care. Appropriate triage was noted as a central necessity in the strategy to reduce amputation during epidemics (STRIDE). Rogers et al proposed the Pandemic Diabetic Foot Triage System, which helps determine the urgency and site needed for treatment. In “Wound Center Without Walls,” Rogers et al8 later described strategies to reduce the COVID-19 exposure risk to the patient while still providing the best practices in wound care in lower risk settings.

Dr. Lee Rogers is going to present this research at the Online Podosymposium which will take place on Saturday December 19, 2020.

To register for this symposium: click here.

Wordpress Social Share Plugin powered by Ultimatelysocial