Diabeetus

The prevalence of diabetes mellitus is growing at epidemic proportions in the United States and worldwide. Most alarming is the steady increase in type 2 diabetes, especially among young and obese people. An estimated 7% of the US population has diabetes, and because of the increased longevity of this population, diabetes-associated complications are expected to rise in prevalence. Foot ulcerations, infections, Charcot neuroarthropathy, and peripheral arterial disease frequently result in gangrene and lower limb amputation...

The current guidelines for the management of diabetes in adults have recommended strict glycemic control, with a target hemoglobin A1c of 7.0%. Increasing evidence has shown that strict glycemic control decreases the risk of developing the organ system complications associated with diabetes. Elevated hemoglobin A1c levels have been theorized as a risk factor for complications after elective foot and ankle surgery. To test this hypothesis, we reviewed the Department of Veterans Affairs national administrative and clinical databases for a 6-year period (January 2008 to December 2013)...

Transmetatarsal amputation is an excellent procedure in the face of nonhealing ulceration, infection, trauma, peripheral vascular disease, and tumors. This article discusses transmetatarsal amputations, the decision-making process, timing of surgery, operative techniques, postoperative management, and salvage of the failed transmetatarsal amputation.