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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)
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.
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)
We developed and validated a survey of foot self-care education and behaviors in 772 diabetic patients with high-risk feet at eight Department of Veterans Affairs medical centers. Principal components analysis identified six subscales with satisfactory internal consistency: basic foot-care education, extended foot-care education, basic professional foot(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)
OBJECTIVE To investigate the relationship between provider coordination and amputations in patients with diabetes. RESEARCH DESIGN AND METHODS The study design was a cross-sectional, descriptive study of process and outcomes for diabetes-related foot care at 10 Department of Veterans Affairs (VA) medical centers representing different geographic regions,(More)
BACKGROUND Foot examinations are widely recommended as a means to reduce amputation risk, but no investigators have studied their independent effect on this outcome. METHODS We conducted a population-based case-control study of primary care provided to Pima Indians from the Gila River Indian Community. Sixty-one Pima Indians with type 2 diabetes and a(More)