Feet walking in grass


From smooth and polished to callused and stinky, feet provide valuable insights to the health of every individual diagnosed with diabetes. High blood sugar can damage nerves in the feet and legs causing pain and numbness called neuropathy. This lack of feeling may cause sores or wound to go unnoticed, become infected and, in worst case scenarios, require amputation.

Lower extremity amputation rates related to diabetes have been gradually increasing each year since 2009. Nearly 800 people with diabetes had a documented non-traumatic lower extremity amputation of a partial to whole foot or leg between July 1, 2017 and June 30, 2018, according to Medicare claims data for the Great Plains Quality Innovation Network’s (QIN) four-state region.

Denise Kolba, RN, program manager for Great Plains Quality Innovation Network“The number of individuals diagnosed with diabetes continues to grow and many more are living with diabetes and unaware,” explained Denise Kolba, RN, program manager for Great Plains QIN.

The American Diabetes Association offers a Type 2 Diabetes Risk Test on their website and promotes risk factor awareness during Diabetes Alert Day on March 26, 2019. Kolba added, “Individuals with risk factors for type 2 diabetes or those with a pre-diabetes diagnosis can prevent the disease through behavior changes. Providers can refer individuals to self-management education programs to receive the tools and support for developing long-term lifestyle change.”

David Lonbaken, DPM, FACFAS, a podiatrist in Pierre, SD, has 23 years of experience in diabetic foot surgery and specializes in limb preservation. He will be sharing best practices and insights during the “Get a Leg Up on Preventing Lower Extremity Amputation” webinar scheduled for April 17. In addition, a patient story will be shared to emphasize the importance of foot exams and self-care.

“As a master trainer with Better Choices, Better Health, I have heard many stories about how quickly complications can arise for those diagnosed with diabetes,” shared Kolba. “Most would think taking your shoes off at the doctor office should be simple enough, but this can be a difficult task for those who struggle with mobility for various reasons.”

Better Choices, Better Health is a six-week self-management education program available for individuals with diabetes to learn proven methods for developing healthy behaviors including foot care. Participants learn ways to prevent foot/leg complications and gain an understanding of the risks associated with poor foot care. The interactive group learning emphasizes the role of both the patient and the provider for preventing complications and teaches best practices for foot care.

  1. Check feet daily for cuts, blisters or red spots
  2. Wash and thoroughly dry feet daily
  3. Trim toenails regularly or visit a podiatrist for thick, yellow, curved or ingrown toenails
  4. Protect feet from hot and cold
  5. Wear shoes and socks
  6. Take off shoes at every provider visit

Additional information on self-management education and diabetes care are available on the Great Plains QIN website along with tools and resources for individuals working to manage or prevent diabetes.