Living with Diabetes in 2019 — Current Trends in Diabetic Foot Care

This number has more than tripled since 1990, and with rates continuing in this direction it’s becoming increasingly important to be aware of current trends related to this condition. One such trend is the recent spike in insulin prices.
 
Surprisingly, there have only been three manufacturers who produce and sell insulin since it’s initial discovery roughly 100 years ago: Eli Lilly, Novo Nordisk, and Sanofi. This has given total control of prices to few hands, and in these hands, the cost of Humalog (short-acting insulin) has increased 585% from 2001 to 2015.
 
Insulin is currently manufactured as a biologic drug, which is an inherently expensive production and regulation process. This could all change thanks to the Biologics Price Competition and Innovation Act, which paves an abbreviated pathway for the creation of biosimilar drug products. But with advances in medicine, patients are relying less on insulin and opting for alternative treatments and generic medications like metformin that treat the condition in the same way.
 
With the rising cost of medications like insulin, some patients are unable to keep up with their treatment regimen. This can lead to uncontrolled blood sugar levels and progressively damaging complications. It has been reported that the rate of amputations in America due to a diabetic foot ulcer increased by 50% from 2009 to 2015, soaring to roughly 4.6 adults out of every 100.
 
 
Patients with diabetes can develop neuropathy, progressive damage to the peripheral nerves. Neuropathy initially affects the nerves that travel the furthest, which is why the feet and fingertips are among the first to lose sensation. The absent sensation can even progress so far as a patient may step on a sharp nail and not even realize it. This has significantly highlighted the importance of diabetic patient’s awareness for their feet.
 
It is recommended for diabetic patients to wear shoes at all times and invest in shoegear that properly accommodates their feet. Just this simple idea will prevent many amputations this year, for ill-fitted shoes can quickly turn a small blister into a trip to the operating room if an infection ensues. Medicare, as well as many private insurances (such Aetna and Blue Cross Blue Shield), cover one pair of custom diabetic shoes and 3 pairs of insoles per calendar year. Shoe brands like New Balance and ASICS have continued to advance the technology in their shoes to accommodate and support the feet. Contact our podiatry office for a complimentary benefits check to see if you are eligible. 
 
Access to this merchandise has never been easier, with many diabetic conferences displaying the latest advances in treatments and products every year. One such trend which has gained popularity in recent years is the conversion to a whole food plant-based diet, which encourages consumption of plant-based foods like fruits, vegetables, greens, grains, berries, and legumes as a way to control blood sugar.
 
Companies like Leafside now offer a deliverable packaged meal of 100% whole food plant based food, which only requires the addition of boiling water. These meals can be purchased in mass quantities, allowing for daily intake of low-glycemic food as an adjunct to medication supplementation. With the continued rise in the cost of medications, patients may be more inclined to control their blood sugars through lifestyle changes like diet and exercise rather than pharmaceuticals.
Author
Dr. Petkov Dr. Velimir Petkov, is a trusted podiatrist practicing at Premier Podiatry in Clifton, NJ. He has over 10 years of experience treating residents of NYC and North NJ for a wide variety of foot and ankle conditions. He prides himself on practicing podiatry with a personalized approach. Patients of Dr. Petkov appreciate his willingness to spend time with them during appointments, educate them about their foot conditions, and provide customized treatment options.

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