Eldering couple walking

Did you Know?

  • In 2012, 29.1 million Americans, or 9.3 percent of the population, had diabetes.
  • Another 8.1 million people are estimated to have the disease, but are undiagnosed.
  • 86 million are estimated to have pre-diabetes, a condition that puts people at risk for the disease.
  • The percentage of Americans with diabetes(age 65 and older) remains high at 25.9 percent; or 11.2 million seniors (diagnosed and undiagnosed).


In response to these statistics, the Centers for Medicare & Medicaid Services (CMS) launched Everyone with Diabetes Counts (EDC), a diabetes self-management education program offering evidence-based training.

The program is designed to improve health outcomes and quality of life among disparate and underserved Medicare populations. Everyone with Diabetes Counts is administered by 14 Quality Innovation Network (QIN)-Quality Improvement Organizations (QIOs), including the Great Plains Quality Innovation Network. EDC Love Your Feet Campaign banner

Consequences of Lower Extremity Amputations

Lower Extremity Amputations (LEAs) have been gradually increasing since 2009. LEAs are of particular concern for racial and ethnic minority beneficiaries (who experience higher rates than whites) and for men, who are more than twice as likely to experience a non-traumatic amputation than women. According to QIN National Coordinating Center data, the LEA rate for men was 112.4 per 100,000 beneficiaries versus 48.3 women per 100,000 beneficiaries.

The consequences of LEAs are serious – negatively impacting a person’s quality of life in a variety of ways, including a shortened life expectancy. When it comes to other quality of life effects, depression and anxiety are common for up to two years after an amputation, according to researchers and some LEA recipients also have social discomfort and body image issues that can limit their physical activity.

The good news is that there are best practices individuals can utilize to prevent LEAs, including knowing the warning signs of Peripheral Artery Disease (PAD). PAD occurs from narrowing arteries due to cholesterol and fatty substances, changes to artery linings and blood becoming stickier due to excess sugar in the blood. The first symptom of a blockage in the leg is pain or cramping in the calves when walking or climbing stairs that goes away with rest. Other possible symptoms are cold feet, numbness and a ‘pins-and-needles’ sensation in the legs. If someone has lost sensation in their feet, a hard-to-heal wound can be the first sign of PAD.

3-Minute Foot Exam

To avoid Peripheral Artery Disease (and, potentially, an LEA), it is key for older adults, especially those with diabetes, to look at their feet once a day and check for anything abnormal. If there is a visible wound that is not healing on its own, a doctor should be contacted immediately. Another important preventive measure is a foot pulse check, which is a key component of the 3-minute foot exam that should be part of any annual medical check-up since a weak pulse is likely a sign that blood isn’t flowing properly into one’s legs and feet.

Besides regular examinations at home and in the doctor’s office, there are other important steps people can take to prevent LEAs. Quitting cigarettes or other tobacco products; increasing physical activity; controlling blood pressure and blood sugar; and keeping up with statin medications can all make a positive health impact.

Learn more about CMS’s Everyone with Diabetes Counts Foot Care Campaign.

The Great Plains Quality Innovation Network is one of the 14 Quality Improvement Organizations that strives to improve the quality of services provided to the Medicare population. Our team consists of Master Trainers and content experts available to assist in developing a referral system, training leaders and facilitating self-management education workshops. For more information, visit our Web site and connect with one of our internal team experts.