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OBJECTIVE To determine the frequency and constellations of anatomic, pathophysiologic, and environmental factors involved in the development of incident diabetic foot ulcers in patients with diabetes and no history of foot ulcers from Manchester, U.K., and Seattle, Washington, research settings. RESEARCH DESIGN AND METHODS The Rothman model of causation(More)
OBJECTIVE To determine the incidence of foot ulcers in a large cohort of patients with diabetes, the risk of developing serious complications after diagnosis, and the attributable cost of care compared with that in patients without foot ulcers. RESEARCH DESIGN AND METHODS Retrospective cohort study of patients with diabetes in a large staff-model health(More)
A number of effective, low-cost strategies are available to identify and treat the person at risk for diabetic foot ulcers and lower-extremity amputation. These strategies must be more widely adopted by all diabetic care providers to maintain the integrity and function of the lower limb, and thus improve the quality of life for people with diabetes.
Lower extremity ulcers and amputations are an increasing problem among individuals with diabetes. Data from the 1983-90 National Hospital Discharge Surveys (NHDS) indicate that 6% of hospitalizations listing diabetes on the discharge record also listed a lower extremity ulcer condition. Chronic ulcers were present in 2.7% of all hospitalizations that listed(More)
OBJECTIVE To describe diet and exercise practices from a nationally representative sample of U.S. adults with type 2 diabetes. METHODS We analyzed data from 1,480 adults older than 17 years with a self-reported diagnosis of type 2 diabetes in the Third National Health and Nutrition Examination Survey (NHANES III). Fruit and vegetable consumption was(More)
Care of veterans and servicemembers with major traumatic limb loss from combat theaters is one of the highest priorities of the Department of Veteran Affairs. We achieved a 62% response rate in our Survey for Prosthetic Use from 298 Vietnam war veterans and 283 servicemembers/veterans from Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) who(More)
OBJECTIVE To identify and quantify risk factors for lower extremity amputation in persons with diabetes mellitus. DESIGN Case-control study. SETTING A Veterans Affairs medical center. PATIENTS Eighty patients having amputation associated with diabetes and 236 diabetic controls without limb lesions were enrolled before surgery from the 21,167 inpatient(More)
OBJECTIVE To describe the association between type of health insurance coverage and the quality of care provided to individuals with diabetes in the United States. DATA SOURCE The 2000 Behavioral Risk Factor Surveillance System. STUDY DESIGN Our study cohort included individuals who reported a diagnosis of diabetes (n=11,647). We performed bivariate and(More)
OBJECTIVE To compare behavioral risk factors and health and disease characteristics among three groups of adults with diabetes: nonveterans, veterans not receiving Department of Veterans Affairs (VA) health care, and veterans using VA services. RESEARCH DESIGN AND METHODS Two data sources were used to describe the veteran population. First, the 2000(More)
PURPOSE Because limited audit/feedback of health status information has yielded mixed results, we evaluated the effects of a sustained program of audit/feedback on patient health and satisfaction. METHODS We conducted a group-randomized effectiveness trial in which firms within Veterans Administration general internal medicine clinics served as units of(More)