Angela Glynn, DPM, consults with a diabetic foot patient at Podiatry Associates of Indiana.
Investigators from the Indiana Center for Regenerative Medicine and Engineering (ICRME) at Indiana University School of Medicine and the IU Health Comprehensive Wound Care Center (IUH-CWC) have turned to community physicians to reach adult patients with diabetic foot complications. Left untreated, these patients could face disability, including limb amputation.
According to the U.S. Centers for Disease Control and Prevention, about 1 in 6 people with disabilities or 16.7% in the United States in 2018, had been diagnosed with diabetes, compared to 1 in 14 without disabilities. Currently, more than 37 million Americans have diabetes, or 11.3% of the U.S. population—11.2% of adults in Indiana.
Understanding these risks, the clinical research arm of the ICRME, the IU Health-CWC, established a strong relationship with Podiatry Associates of Indiana (PAI) to support ongoing studies. ICRME investigators seek to identify biomarkers that can guide treatment, predict how a diabetic foot ulcer may heal and understand the likelihood of ulcers recurring.
“Through our partnership with Podiatry Associates of Indiana and an advanced approach to manage diabetic foot ulcers, there is great promise in identifying biomarkers to improve the standard of care for these patients with diabetic foot complications,” said Chandan K. Sen, PhD, distinguished Professor and the J. Stanley Battersby chair of surgery, director of the ICRME at the IU School of Medicine and executive director of IUH-CWC. “Our long term goals are to help prevent further complications, ulcer recurrence and limb amputation.” Sen is the contact principal investigator of the national Diabetic Foot Consortium sponsored by the National Institutes of Health.Podiatry Associates is enrolling patients for the consortium.
Collaborations enhance clinical intervention
The division of plastic surgery, a primary collaborator with the ICRME, is working with the Podiatry Associates of Indiana to support diabetic foot clinical research studies, said Gayle M. Gordillo, MD, the Dr. Sanford and Thelma E. Glanz Professor and Chief for the division of plastic surgery, Department of Surgery, at the IU School of Medicine. “A community approach to clinical research can increase study participation and more importantly, support clinical intervention to support wound healing and new breakthroughs in our treatment for patients.”
“We’re going to reach so many more patients,” Dr. Glynn said. “The reason these studies are of interest to us is that we see our patients fight foot ulcers over and over. If we can identify a biomarker to identify people who might have the potential for recurrence, we can help deliver better wound care.”
Ken Williams, a retired pharmacist who resides on the southeast side of Indianapolis, is one of them. He has lived with Type 1 Diabetes since he was 29 and was at great risk for complications for foot ulcers. Now in his 70s, he has neuropathy and pressure sores, and lost the third and fourth digit from his right toe.
He said he was pleased to hear studies such the ones Indiana University are conducting are available and sees Dr. Glynn at the Greenwood PAI clinic.
“It is encouraging,” Williams said. “If we can figure out a better way to help people, it will be better for everybody in the long run.”
Daniel Miller, DPM, who also practices at Podiatry Associates of Indiana, is eager to support research that may benefit his patients and others in the future.
Preventing diabetic foot ulcerations
“I look forward to help find more predictive methods to prevent diabetic foot ulcerations,” Dr. Miller said. “Recurrent diabetic foot ulcers require a lot of time, vigilance and care between the patient and physician. If we can do more to help prevent them, there is a better chance for the patient to lead to a better quality of life.”
Sandra Raynor, DPM, owner and president of Podiatry Associates of Indiana and past president for the Indiana Podiatric Medical Association, oversees 10 offices for PAI and sees patients at her office on the northwest side of Indianapolis. She said that their podiatry practice conducts approximately 80,000 patient visits a year, many patients with diabetes.
She describes diabetes as an epidemic that can result in tragic complications, including amputation.
She emphasized that many of the complications can be avoided with preventative care.
“The American Diabetes Association recommends regular podiatry care,” Dr. Raynor said. The frequency depends on whether the patient is experiencing any complications. I would recommend anyone diagnosed with diabetes establish a relationship with a podiatrist.”
She welcomes the opportunity to expand these studies to other sites.
“We’re happy to be involved in any research that can help diabetic patients lead active and healthy lives,” Dr. Raynor said. “If complications are caught quickly, there can be better outcomes.”
The views expressed in this content represent the perspective and opinions of the author and may or may not represent the position of Indiana University School of Medicine.
Angie Antonopoulos is a Communications Generalist for the IU School of Medicine. Previously she served the Department of Surgery and the Indiana Center for Regenerative Medicine and Engineering and is now supporting the Krannert Cardiovascular Research Center for the Department of Medicine. She has more than a decade of experience in health communications for higher education, advocacy, government and contract research organizations.