CLEAR Consultant’s Clinics offer unparalleled experience and expertise in the medcal and surgical management-- and prevention-- of complex lower extremity disease. Visitors to Chicago from the US and abroad are welcome to inquire about our various comprehensive assessment programs. www.theclinics.nethttp://www.theclinics.nethttp://www.theclinics.net/shapeimage_16_link_0

There are currently more than 21 million known persons with diabetes in America, and the number grows by approximately one-half million annually.  It has been estimated that an equal number of persons with diabetes remain undiagnosed.  A person develops diabetes when their body is unable to maintain a normal level of sugar in the blood.  Insulin, the hormone that regulates the level of sugar, is either not used properly by the body or it is produced in inadequate amounts.  When this occurs, diabetes is the result.


Juvenile or, more appropriately, Type 1 diabetics, respond to treatment with daily insulin injection and represent 10% of the diabetic population.  The remaining 90% of diabetics are adult-onset or Type 2, typically over 35 years of age, often overweight, and can be treated with diet, exercise, oral anti-diabetic medications and/or insulin.


Frequent signs of the presence of diabetes are:

  1. ✦increased thirst

  2. ✦frequent urination

  3. ✦chronic fatigue

  4. ✦rapid unexplained weight loss

  5. ✦slowly healing sores and cuts

  6. ✦frequent infection

  7. ✦blurred vision

  8. ✦sweating from the waist up with dry skin from the waist down

  9. ✦tingling and numbness in the hands and feet


The long-term presence of elevated blood sugar levels commonly result in damage to the eyes, kidneys, heart and feet.  Due to damaged small blood vessels and cataract formation, loss of vision may occur.  Vascular disease increases the potential for heart disease and stroke. It may impair kidney function, and in the feet, it may result in diminished circulation along with reduced ability to fight off infection and heal wounds. Damage to nerves, known as neuropathy, may result in a lack of sensation.


These factors often result in complex foot problems that may require major foot surgery or even amputation of the foot or leg.  Small cuts, skin cracks, burns, sores, sore corns, ingrown nails, bunions and other common foot problems caused by ill-fitting shoes may become infected and result in gangrene.  These patients, due to the neuropathy (lack of sensation), are often unaware of the existence of these problems until it is too late to reverse the complications.


The management of complex diabetic foot problems requires a team approach to ensure success in the treatment of the dangerous complications of the disease, and should include the podiatrist, primary care physician, the vascular surgeon, the nurse educator, the physical therapist, the nutritionist and the pedorthist, who has the responsibility to assure proper non-irritating footwear to protect patients' feet from the constant pressure and irritation caused by walking. Numerous other practitioners may also actively participate on the team, depending on its particular construct. These include orthopaedists, infectious disease specialists, physiatrists, and psychologists.


One of the most important components in the care of the person with diabetes is preventing foot complications from occurring.  Medical management must be ongoing while the podiatrist and pedorthist care for the local complications.


The foot specialist, in cooperation with other physicians and healthcare providers, is able to formulate a team-approach to foot care that can be enormously beneficial.  


Success in the care of foot problems in diabetic patients results when there is overall control of each component of the disease. Diet, medication, exercise, and the management of blood sugar are the basis of control.  This is accomplished through cooperation between the primary care physician, the nurse educator, the nutritionist and the patient.

20 Steps Toward Foot HealthPatient_add_info.html
Recommended Shoes & SocksPatient_add_info.html
Links to Diabetes CommunityPatient_add_info.html
ADA Local Eventshttp://www.diabetes.org/communityprograms-and-localevents/whatslocal.jsp
ADA Foot Carehttp://www.diabetes.org/type-2-diabetes/foot-care.jsp

CLEAR's research unit is amongst the largest of its kind in the world.  We have active research going on in many unique areas studying cutting-edge treatments for foot and ankle conditions. These include:


1. Healing chronic wounds

2. Infections of the foot and ankle

3. Prevention of diabetic foot complications

4. Treatment of nail disease (fungal and ingrown toenails)

5. Treatment of nerve damage and pain to the foot and ankle in persons with diabetes


If you are interested in potentially participating, feel free to contact CLEAR's clinical research unit to see if you qualify and might benefit from projects in the program:


If you do not have access to the Chicagoland area, where CLEAR is located, then we are more than happy to direct you to a clinical research unit in your part of the world. Our team actively participates with groups from all parts of the USA and more than 30 nations on 6 continents. 


CLEAR's Clinical Research Unit
Scholl’s Center for Lower Extremity Ambulatory Research (CLEAR)
at Rosalind Franklin University of Medicine and Science
3333 Green Bay Road
North Chicago, IL 60064
CLEAR@rosalindfranklin.edu
847-578-8439

ADA Foot Care Researchhttp://www.diabetes.org/diabetes-research/summaries/footcare.jsp
Find a Podiatristhttp://iweb.apma.org/buyersguide/professionalsearch.aspx?x=14&y=7
Diabetic Foot Disease: an interactive guidehttp://www.diabetes.usyd.edu.au/foot/index.html
National Library of Medicine Tutorial on Diabetic Foot Carehttp://www.nlm.nih.gov/medlineplus/tutorials/diabetesfootcare/htm/index.htm
Amputee Coalition of America (ACA) Support Grouphttp://www.amputee-coalition.org/npn_about.html
Stairway to Amputationstairway_to_amputation.html

Diabetes and Amputation Statistics

Additional Patient Information

CLEAR Physicianhttp://www.theclinics.net/

  1. BulletDiabetes affects 21 million people in the US and 189 million people worldwide.  By the year 2025 the prevalence of diabetes is expected to rise by 72% to 324 million people globally.

American Diabetes Association

 

  1. Bullet60-70% of those with diabetes will develop peripheral neuropathy, or lose sensation in their feet.

Dyck et al.  Diabetic Neuropathy 1999

 

  1. BulletUp to 25% of those with diabetes will develop a foot ulcer.

Singh, Armstrong, Lipsky.  J Amer Med Assoc 2005

 

  1. BulletMore than half of all foot ulcers (wounds) will become infected, requiring hospitalization and 1 in 5 will require an amputation.

Lavery, Armstrong, et al.  Diabetes Care 2006

 

  1. BulletDiabetes is attributed to about 80% of the 120,000 nontraumatic amputations performed yearly in the United States.

Armstrong et al. Amer Fam Phys 1998

 

  1. Bullet“Every 30 seconds, somewhere in the world, a limb is lost as a consequence of diabetes”

The Lancet (cover), Nov. 2005

 

  1. BulletAfter a major amputation, 50% of patient will have their other limb amputated within 2 years.

Goldner. Diabetes 1960

Armstrong, et al, J Amer Podiatr Med Assn, 1997

 

  1. BulletThe relative 5-year mortality rate after limb amputation is at least 50%. When compared with cancer – it is second only to lung cancer (86%).  (Colorectal cancer 39%, Breast cancer 23%, Hodgkin’s disease 18%, Prostate cancer 8%)

Armstrong, et al, International Wound Journal, 2007

Amer Cancer Society; Facts & Figures 2000

Singh, Armstrong, Lipsky et al. J Amer Med Assoc 2005

CLINICAL RESEARCH PARTICIPATION