These data appear to support the effectiveness of real-time interactive telemedicine consultation in the management of diabetes-related forefoot ulceration.

The healing rate of forefoot ulcerations in patients with diabetes using alternative off-loading methods or a total contact cast appeared to be comparable when the method was selected based on location of ulcer, patient age, and duration of ulceration.

OBJECTIVE -To compare patient outcomes 1 year before and 1 year after enrollment in a comprehensive diabetes lower-extremity amputation prevention program. RESEARCH DESIGN AND METHODS-Outcome data were obtained on 197 patients enrolled in the Louisiana State University Health Sciences Center Diabetes Foot Program, which provides foot care to a predominantly low-income African-American population in Louisiana. Data were obtained using a structured interview administered by a registered nurse. Recordings were made of number of days with an open foot ulcer, number of times hospitalized for a foot problem, number of days spent in the hospital for a foot problem, number of visits to the emergency room for a foot problem, number of times an antibiotic was prescribed for a foot problem, number of all foot operations, number of lower-extremity amputations, and number of missed workdays for a foot problem. Data were obtained on all patients at the initial visit and at the 1-year follow-up.RESULTS -Analysis of data showed a reduction in foot-related ulcer days (Ϫ49%), hospitalizations, (Ϫ89%), hospital days (Ϫ90%), emergency room visits (Ϫ81%), antibiotic prescriptions, (Ϫ57%), foot operations (Ϫ87%), lower-extremity amputations (Ϫ79%), and missed workdays (Ϫ70%) after 1 year of comprehensive foot care compared with the 1-year period before treatment.CONCLUSIONS -This single cohort outcome study showed a large reduction in footrelated complications after the first year of comprehensive preventive foot care.