Screening and Educating Patients on PAD to Stop Diabetes Before It Starts

Next month, a team of physicians will use education, outreach, and advocacy to decrease the number of amputations in people with diabetes or peripheral arterial disease (PAD)—as well as improve their quality of life.

The Save a Leg Save a Life Foundation (SALSAL), along with community and industry partners, will be conducting a free community screening and educational event on March 10 at the First Baptist Church, 508 Second St. in Natchitoches, LA.

The community screening will focus on areas including vision, vitals, glucose levels, nonvascular arterial testing, and balance/gait analysis. Following that, a community education event will focus on vision, diabetes, complications, congestive heart failure, and more. After that, there will be education for health care workers in wound infection. The last event of the day will be a roundtable panel discussion with the following physicians: Jim Knecht, MD (keynote speaker); Desmond Bell, DPM, CWS, FFPM RCPS (Glasgow) (SALSAL founder); Elizabeth Faust, NP (Tower Health); Tracey Paulfrey (SALSAL board member); and Cissy Picou, MD (Natchitoches Regional Medical Center Wound Center). Dr. Knecht will speak of an experience in which he almost lost limb and life.

Following that, on March 11, Natchitoches Regional Medical Center will host a lunch and learn educational session. Dr. Knecht, Dr. Bell, and Stephen Rice, MD, will help us kick off this lecture. 

These events allow us to concentrate on what's really important—helping clinicians and members of our communities and introducing the basics to further enhance their knowledge and skills. 

As Dr. Bell noted a few months ago in a Today’s Wound Clinic article, we are experiencing not only an increase in minor amputation, but in amputation at every level from toe to above the knee. Between 2010 and 2015, amputation rates rose to 4.6 per 1,000 patients, exceeding their previous high in 2000.¹ In addition, the increases in rates of total, major, and minor amputations were most pronounced in young (age 18–44 years) and middle-aged (age 45–64 years) adults and more pronounced in men than women.¹

SALSAL is a non-profit whose mission is "to reduce the number of lower extremity amputations and improve the quality of life of those who are afflicted with wounds and complications from diabetes and PAD." Dr. Bell, the founder, has started organizing community screening events to help educate members of respective communities on the importance of not just recognizing their risk factors, but also to teach them how to be advocates for themselves and their loved ones. He emphasizes the importance of prevention when it comes to diabetes and PAD.

“We believe doing events like this will help create awareness in addition to helping at-risk group members not only understand their risk factors, but to also help them navigate the system (get them to local specialists if findings obtained during the screenings are a concern),” says Dr. Bell.

Dr. Bell notes SALSAL’s first event in Miami was at a church located in an underserved neighborhood (all Black and undocumented Haitians). SALSAL found significant numbers of patients with previously undiagnosed PAD and made referrals to local doctors with the help of the Southeast Florida component of the American Podiatric Medical Association (APMA). 

At the event, Dr. Bell and our team plan on performing lower extremity screenings for diabetic foot ulcers, PAD screenings among others at the event. Patients found to have concerns during the screening will be referred to local specialists to expedite further evaluation.  

Dr. Bell compares this campaign to the impact breast cancer awareness campaigns have made. People have become informed about their risk factors, have learned to perform self-examinations, and have had a lot of fears reduced in the process. As a result, he notes death rates from breast cancer have continued to decrease while treatments have improved.

“So many more people are at risk due to diabetes and PAD,” says Dr. Bell. “If we can help the general population understand the urgency that drives our efforts and why becoming proactive is so important, then SALSAL may become a factor in lowering our rising amputation rates, and have an impact much in the way breast cancer awareness has benefited so many individuals as well as society.”  

The events will also include industry partners Kerecis, Wound Vision, Kent Imaging, and AOTI. The focus is to also educate clinicians on evidence-based practices but also to learn the science behind their products. When I first started in this rural area, we lacked resources and education, so this is my way to bring needed education to areas needed. 

Community Sponsors include Elara Caring, Kindred at Home, Natchitoches Regional Medical Center (NRMC), Dr. Pete Wardell/Family Eye Care, MIIGS, Louisiana Extended Care Hospital–Natchitoches, the Frank & Lizzie Show, the NRMC Walk in Clinic, the NMRC Wound Care Clinic, Professional Home Health and Hands in Hands Hospice, and Lagniappe Home Care.

Donations to The Save a Leg Save a Life Foundation will be used to continue the patient assistance/philanthropic fund to help others in need with items related to lower extremity amputation prevention.

Frank Aviles Jr. is Wound Care Coordinator for Natchitoches (LA) Regional Medical Center; wound care and lymphedema instructor at the Academy of Lymphatic Studies, Sebastian, FL; physical therapy (PT)/wound care consultant at Louisiana Extended Care Hospital, Natchitoches; and PT/wound care consultant at Cane River Therapy Services LLC, Natchitoches.

Dr. Bell is an Executive Physician Coach for MD Coaches LLC and is a Certified Wound Specialist. He is Chief Medical Officer for Omeza, Founder and President of the Save A Leg, Save A Life Foundation, and a Fellow of the Royal College of Physicians and Surgeons of Glasgow.

Click here to download a PDF of this article.

Reference

1.    Geiss LS, Yanfeng L, et al. Resurgence of diabetes-related nontraumatic lower-extremity amputation in the young and middle-aged adult U.S. population. Diabetes Care. 2019 Jan; 42(1):50–54.