||Rith-Najarian, S; Dannels, E; Acton, K.|
||Preventing amputations from diabetes mellitus: the Indian Health Service experience|
||West Indian med. j;50(supl.1):41-43, Mar. 1-4, 2001.
||Apresentado em: Annual International Conference of the University Diabetes Outreach Project, 7, Ocho Rios, Mar. 1-4, 2001.
||With the heavy burden of diabetes mellitus among American Indians and Alaskan Natives, lower-extremity amputation (LEA) has become a common complication. Rates of diabetes-related LEA are 2-3 times those observed in other diabetic populations. During the past 12 years, the Indian Health Service (IHS) has made LEA prevention a public health priority. From 1988 to 1992 screening criteria based on simple examinations were developed and validated in primary care Settings. Prevention efforts have focused on targeting high-risk individuals for self-care foot education, provision of protective footwear, and routine podiatry care. Follow-up studies in Alaska and northern Minnesota saw 25-50reductions in LEA rates associated with these interventions. In settings where these efforts were augmented with system changes, such as team coordination, patient-tracking systems, comprehensive footcare practice guidelines, flowsheets, and outreach programmes, LEA incidence was reduced by 50-75. Efforts are currently underway to disseminate system-based approaches for comprehensive diabetic footcare and to expand the availability of foot care resources to tribal communities served by the IHS.|
Educação de Pacientes como Assunto
Pé Diabético/prevenção & controle
Fatores de Risco
Serviços de Saúde do Indígena/normas
United States Indian Health Service
||BR1.1 - BIREME|