Diabetes and The Internet
by Stephen M. Pribut, D.P.M., F.A.C.F.A.S.
It is estimated that there are currently 16 million people in the United States with diabetes. More than half of these people are undiagnosed. Approximately 800,000 are Insulin-dependent diabetics and approximately 8 million are non-insulin dependent diabetics. Approximately 45 billion dollars a year is spent directly on health care related to diabetes. Another 47 billion dollars per year is spent on indirect costs such as disability, work loss, and premature mortality relating to diabetes.
Diabetes is the seventh highest cause of death in the United States and the largest cause of non-traumatic amputation. Amputation costs of diabetics total over $500 million. Eighteen percent of all deaths in adults over the age of 25 occurred in individuals who have diabetes. Each year there are approximately 625,000 new cases diagnosed each year. Approximately 9.6% of African-Americans and 6.2% of Caucasians are estimated to have diabetes.
Podiatric physicians are an important component of the diabetic health care team. Many times we are the first to see the signs, symptoms, and complications of this disease. As the baby-boomers age, the incidence of diabetes is bound to increase since over 40% of those older than 65 years of age have either impaired glucose tolerance or non-insulin dependent diabetes. We all must stay abreast of information about diabetes to keep the feet of our diabetic patients in working order. Through the use of the World Wide Web information is readily and rapidly available for both physicians and patients.
The support of a patientís family is important to the individual with diabetes. Besides the information contained in your office handouts, physicians may also lead the patient and their family to authoritative websites that contain information about diabetes. The American Diabetes Association (ADA) has a site at http://www.diabetes.org/ that is informative to both patients and practitioners alike. This site contains news and information on breaking research and current legislation that affects diabetics, a summary of research sponsored by the ADA and a members only page with links to the text of many of their professional and lay journals. Abstracts are available to non-members.
There are several sources on the web for children with diabetes. The Juvenile Diabetes Foundation has an informative site at http://www.jdfcure.com/index.html. Their site includes "What You Should Know About Diabetes" and information on their publications "Countdown" and "Countdown For Kids." The "Children With Diabetes Home Page" at http://www.castleweb.com/diabetes/ contains information specifically for diabetic children and their families. This site is the best one available for children and their parents. One of their unique pages called "Kids Voices" has links to home pages of "kids with diabetes." They also have an e-mail pen pal page for children with diabetes. For parents there are several supportive areas here, including "Ask The Diabetes Team", a listing of camps for children with diabetes, diabetes basics, and a variety of links to informative sites for parents of diabetic children.
A good starting point for physicians is the "Doctorís Guide To Diabetes Information & Resources" (http://www.pslgroup.com/DIABETES.htm)". This comprehensive area contains medical news and alerts, links to general articles on diabetes, and voluminous links to other sites. This is a great place to begin your exploration of diabetes on the Internet. The Diabetes Monitor is another attractive site with a well organized set of web links. This is another fine spot to look for information about diabetes.
The National Diabetes Fact Sheet (http://www.cdc.gov/nccdphp/ddt/facts.htm), compiled by the Center For Disease Control, contains much demographic information about the diabetic population. The CDC Diabetes home page at http://www.cdc.gov/nccdphp/ddt/ddthome.htm also has online the document "The Prevention and Treatment of Complications of Diabetes Mellitus: A Guide for Primary Care Practitioners". This document, initially published in 1991, contains much information about the assessment and treatment of diabetes and the team approach to the management of this disorder. A section on disorders of the foot is also included.
The National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health (http://www.niddk.nih.gov/NIDDK_HomePage.html) also has an informative site for patients and practitioners. A highlight on their page is the national foot care awareness campaign - "Feet Can Last a Lifetime." I learned from this site that the campaign was supported by 10 organizations or institutions including the Veterans Administration, the ADA, American Association of Diabetes Educators, and the California College of Podiatric Medicine. Notably absent was the APMA. If you are creating your own patient information page, I would suggest surfing here and linking to their page of 10 tips for diabetics on good foot care.
USENET, the "old school" bulletin board of the Internet, has two areas specifically devoted to diabetes. The newsgroup news:misc.health.diabetes is described as an ongoing "discussion of diabetes management in day-to-day life." The newsgroup news:alt.support.diabetes.kids is dedicated to diabetic children as its title suggests. Many newsgroups are unmoderated. This means that anyone can post whatever they like, without any responsibility to be accurate. This is not a good source of information for the practitioner, but it is an area of discussion for many patients. They will have to be alert to discern the helpful information from misinformation. USENET newsgroups may be accessed through a browser such as Firefox, MS Explorer, Safari, or by using a standalone newsreader such as the freeware Free Agent Newsreader available at: http://www.forteinc.com/getfa/download.htm.
There are many other sites devoted to diabetes on the Internet. The ones listed here are excellent starting points. To supplement these you can follow the links from the sites you visit or use one of the search engines such as Yahoo or Altavista. The ready availability of materials, such as these on diabetes, demonstrates the use of the Internet as a valuable source of rapid information transfer. Someday soon youíll even be able to participate in continuing education activities on this same medium.
Diabetes Information Links:
American Diabetes Association
Juvenile Diabetes Foundation
Children With Diabetes Home Page
Doctorís Guide To Diabetes Information & Resources
National Diabetes Fact Sheet
Center For Disease Control
National Institute of Diabetes and Digestive and Kidney Diseases
Stephen M. Pribut, D.P.M. is a Clinical Assistant Professor of Surgery at the George Washington University Medical Center. His web site is available at http://www.drpribut.com/sports/spsport.html.