ADVERTISEMENT
All Multidisciplinary Teams, All the Time: Treat the Patient and Not the Wound
Given that diabetes affects so many organs in the body, team-based care is particularly crucial for patients with diabetic foot ulcers. This author details how a multidisciplinary approach can save lives and limbs.
It’s human nature to pay more attention to acute, life-threatening events than to medical conditions that develop slowly and insidiously. That’s why diabetes is called the “silent killer.” It’s also human nature to pay more attention to painful conditions than non-painful ones. That’s a major reason that neuropathic diabetic foot ulcers so often end in amputation.
Unfortunately, teamwork does not come naturally to independent-minded clinicians. The disease of diabetes can affect nearly every organ system and is the perfect example of why team-based care is vital.
However, national statistics indicate we are not doing a very good job of managing this complex condition. The most recent analysis of the direct and indirect annual cost of diabetes was an astronomical $327 billion.1 In 2018, 10.5% of the U.S. population had diabetes (34.2 million people) and 1 in 5 diabetic foot ulcers (DFUs) ended in some level of amputation. In 2016, a total of 7.8 million hospital discharges in adults included diabetes among the diagnoses. The conditions for which they were hospitalized included major cardiovascular diseases (1.7 million), ischemic heart disease (438,000), stroke (313,000), lower extremity amputation (130,000), hyperglycemic crisis and hypoglycemia. When there is a foot infection, the risk of hospitalization is 55.7% greater and the risk of amputation is 154.5 times greater.2
We need to improve the delivery of all aspects of care.
