[Congressional Record Volume 151, Number 49 (Thursday, April 21, 2005)]
[Extensions of Remarks]
[Pages E713-E714]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




REGARDING THE DIABETIC FOOT COMPLICATION AND LOWER EXTREMITY AMPUTATION 
                         REDUCTION ACT OF 2005

                                 ______
                                 

                         HON. RICHARD H. BAKER

                              of louisiana

                    in the house of representatives

                       Wednesday, April 20, 2005

  Mr. BAKER. Mr. Speaker, as the Federal Government seeks to provide 
better healthcare to more Americans while reducing healthcare expenses, 
we must look at the benefits of preventive care programs. Education, 
screening and preventive treatments can save patients and government 
significant heartache and expense. One area where preventive care shows 
tremendous promise is the treatment of diabetic foot complications.

[[Page E714]]

  Approximately 18 million Americans have diabetes, an increase of 61 
percent since 1990. As diabetes rates continue to rise, the cost of 
treating diabetes, already estimated at $132 billion, will certainly 
rise. One of the most serious complications diabetes patients face is 
poor circulation and infections in their lower extremities. In fact, 
diabetic foot infections are the most common reason for hospital 
admissions among persons with diabetes, accounting for 25 percent of 
all diabetic admissions in the United States. Loss of circulation and 
feeling present real challenges to people with diabetes and 15 percent 
of people with diabetes will experience a foot ulcer, and between 14 
and 24 percent of those with a foot ulcer will require amputation. Each 
year approximately 86,000 non-traumatic lower-limb amputations are 
performed each year among people with diabetes.
  Lower extremity amputations cost Americans $2 billion a year, with 
each procedure totaling approximately $60,000. Although private 
insurance bears some of this expense, Medicare is saddled with many of 
these costs since these complications disproportionately affect the 
elderly. For example, analysis of the 1995 Medicare claims revealed 
that lower-extremity ulcer care accounted for $1.45 billion in Medicare 
costs and contributed substantially to the high cost of care for 
diabetics, compared with Medicare costs for the general population. In 
fact, the Medicare costs for diabetes patients with foot ulcers is 3 
times higher than for diabetes patients in general, and inpatient care 
accounts for 74 percent of diabetic ulcer-related costs.
  Fortunately, cost effective ulcer prevention and treatment 
interventions have proven effective at reducing foot complications and 
lower extremity amputations at only a fraction of the cost. Studies 
show that a multidisciplinary approach, including preventive 
strategies, patient and staff education, and treatment of foot ulcers, 
can reduce amputation rates up to 85 percent. Nationwide reductions of 
this size would save Americans as much as $1.7 billion a year. The 
American Diabetes Association estimates that comprehensive foot care 
programs can reduce amputation rates up to 85 percent. Furthermore, the 
LSU Health Sciences Center Diabetes Foot Program in Baton Rouge, 
Louisiana enrolled over 2,300 diabetes patients with published research 
demonstrating their prevention and treatment program resulted in an 89 
percent reduction in foot related hospitalizations, an 81 percent 
reduction in emergency room visits, and a 79 percent reduction in foot 
amputations at a cost of about 50 percent of standard care. 
Unfortunately, a 2002 National Institutes of Health (NIH) study shows 
that less than 2 percent of adult diabetics receive the level of care 
recommended by the American Diabetes Association.

  With sound research showing the benefits of preventive care for 
people with diabetes, now is the time to commission a large, 
authoritative study on the issue. The results of this study will serve 
as solid evidence to public and private organizations of the need for 
preventive care to aid in the reduction of diabetes foot complications 
and will help foster technical and policy changes to healthcare 
programs. In addition, thousands of Americans who participate in this 
study will benefit from the education and treatment provided by this 
grant program.
  Mr. Speaker, I hope members will consider these facts and cosponsor 
the ``Diabetic Foot Complication and Lower Extremity Amputation 
Reduction Act of 2005.''

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