Diabetes Dialogue: Diabetic Foot Ulcers and Social Determinants of Health

For people with diabetes, awareness and management of comorbidities are essential parts of everyday life. Oftentimes, when discussing comorbidities in those with diabetes, heart failure and chronic kidney disease will dominate the conversation as a result of the immediate threat both pose on mortality risk and quality of life in these patients.

Although the field has made advancements to reduce the risk of amputation, diabetic foot ulcers still pose a significant threat to both quality of life and mortality among these patients. According to contemporary date, the lifetime risk of developing foot ulcers among people with type 2 diabetes is between 19-34% and estimates purport 9.1-26.1 million individuals with diabetes globally develop foot ulcers every year. As with almost every comorbidity in diabetes, social determinants of health can play a role in increasing or attenuating this risk for many patients. However, many individuals and organizations have been determined to make a difference for these patients and mitigate the detrimental impact of social determinants of health.

At the 83rd Scientific Sessions of the American Diabetes Association (ADA 2023), hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, recorded more than half a dozen special edition episodes of Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives, including an episode with Gary Rothenberg, DPM, a podiatrist and assistant professor of internal medicine in the Division of Metabolism, Endocrinology, and Diabetes at the University of Michigan as well as the director of Medical Affairs with Podimetrics. Podimetrics, based in Boston, MA, is the creator of the SmartMat and integrated clinical and patient support services that can help save the limbs and lives of complex patients living with diabetes.

During the episode, Rothenberg discusses the importance of educating patients and clinicians on the risks posed by foot ulcers in people with diabetes as well as how social determinants of health influence the risk of foot ulcers. In addition to joining hosts Isaacs and Bellini for a special edition episode of Diabetes Dialogue, Rothenberg also served as a panelist for a session on the use of artificial intelligence in diabetes foot disease during his time at ADA 2023.

Relevant disclosures for Dr. Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Dr. Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others. Relevant disclosures for Dr. Rothenberg include Podimetrics.

References:

1. Armstrong DG, Boulton AJM, Bus SA. Diabetic Foot Ulcers and Their Recurrence. N Engl J Med. 2017;376(24):2367-2375. doi:10.1056/NEJMra1615439
2. McDermott K, Fang M, Boulton AJM, Selvin E, Hicks CW. Etiology, Epidemiology, and Disparities in the Burden of Diabetic Foot Ulcers. Diabetes Care. 2023;46(1):209-221. doi:10.2337/dci22-0043