Timeline of IHMA 's original submission and subsequent actions to get Diabetic Foot Ulcers approved. This landmark decision was important because this is the first new indication to be added by Medicare for HBOT in over 18 years. This means more hyperbaric clinics opening across the nation, needless amputations have been significantly lowered, and is an important building block for other hyperbaric indications to be recognized and added for treatment and insurance reimbursements.
Paul G. Harch, M.D. Director
Myra Varnado, RN CWOCN, Clinical Manager
Wound Care and Hyperbaric Medicine Department
Diabetes foot wounds are an enormous health care problem. Every year 2% of the greater than 18 million diagnosed diabetes patients in the United States develop a foot ulcer. For those diabetes patients with peripheral neuropathy, 5 to 7.5% will develop a foot ulcer each year. In 2006, 65,700 lower extremity amputations were performed among people with diabetes. The personal loss and disability is substantial and is accompanied by significant health care costs. Diabetes foot ulcers result in more hospitalizations than any other complication of diabetes. In 1999 the cost of treating a foot ulcer over two years was $28,000.
The greatest personal risk and impact on health care costs, however, is the propensity of diabetes foot wounds to result in extremity amputations. Every year 12-24% of diabetes foot wounds result in amputation; this is over 60% of all non-traumatic amputations in the U.S. According to the CDC, diabetes related neuropathy with wounds has a relapse rate of 66% over 5 years, and 12% of people with wounds progress to amputation. The cost of an amputation exceeds $45,000, but puts the diabetes patient at risk for foot wounds on the opposite leg and eventual bilateral amputation. Fortunately, a substantial portion of these amputations are preventable. Prevention of lower extremity amputation is the primary goal of the LSU IPH Wound Care and Hyperbaric Medicine Department.