An Update on the ADA’s Amputation Prevention Alliance

On Wednesday morning, Dr Robert Gabbay, chief scientific and medical officer of the American Diabetes Association (ADA), presented an update on the Amputation Prevention Alliance, which the ADA established in partnership with innovators, clinical experts, leading health foundations, leaders in the diabetes community, policymakers, and provider groups with the mission of disrupting the curve of amputations among low-income and minority individuals with diabetes. 

Dr Gabbay began by stating what is known: 

•  Lawmakers in Washington DC and in states lack understanding and awareness of the situation
•  Peripheral arterial disease (PAD) and critical limb ischemia remain relatively unknown disease states
•  For some, the care received, as well as the chances of avoiding an amputation, comes down to race, income level, or zip code.
•  In some communities, the perception is that an amputation is simply a part of living with diabetes. 

To reduce the number of amputations in the United States, the Amputation Prevention Alliance was established with 4 goals in mind: improve provider awareness and practice, make preventive treatment more accessible , demonstrate the cost of preventable amputations, and help at-risk patients better understand and prevent amputations.

Dr. Gabbay discussed the steps that the Alliance has taken to meet these goals, which include: 

• Formed a clinical advisory working group and partnered with watchdog organization on establishment of quality metrics for hospitals
• Drove changes in state Medicaid coverage and reimagined federal legislation designed to prevent amputations through better, earlier care and increased access to medical interventions
•  Hosted 2 webinars and written opinion pieces arguing for improvements to the healthcare system to address the US amputation epidemic
•  Engaged the ADA professional practice group on needed changes and/or updates to standards of care and conducted focus groups of at-risk patients to recognize what information they need
•  Built a microsite on diabetes.org to educate health care providers and the public about the risks of amputation, how to navigate early signs of PAD/CLI, and how to access affordable resources

He also spoke about the Amputation Reduction and Compassion Act,  Introduced by Congressman Donald M. Payne, Jr. (D-NJ) alongside Congressmen Ruben Gallego (D-AZ), Jeff Van Drew (R-NJ), and Chris Smith (R-NJ). The bipartisan Act  will create a PAD education program for primary care professionals, establish Medicate and Medicaid coverage for PAD screening services, require the development of quality metrics to prevent amputations, and develop a pilot program to support major amputation prevention. 

Dr Gabbay concluded his presentation by reminding AMP attendees that the ADA cannot do this alone and emphasized the importance of building an alliance of aligned advocates to prevent amputations in the United States.