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Is Podiatric Care Indicated in Pregnant Patients With Pre-existing Diabetes of >10 Years Duration? [19D]

INTRODUCTION: Diabetes affects over 6% of the population and can lead to severe end organ damage. Thus, obstetricians screen their patients for ophthalmologic, renal, and cardiac damage. One aspect often overlooked is the podiatric exam, a common site for diabetic pathology. This study sought to determine the incidence of podiatric pathology in asymptomatic diabetic pregnant patients of >10 years duration irrespective of diabetic type. METHODS: We conducted a retrospective medical chart review from January 1, 2005 to December 31, 2005 and identified 98 patients with pre-existing diabetes of greater than 10 years duration who underwent complete podiatric exam and diabetic foot care counseling by a board-certified podiatric surgeon. RESULTS: Of the 98 patients included, we found an overall podiatric pathology presence of 52.0% (N=51); onychomycosis 19.8%, dyshidrosis 7.1%, fissure 5.1%, prokeratosis 3.1%, metatarsalgia 8.1%, tinea pedis 4.1%, *neuropathy 13.3%, *ulceration 4.1%, *periostitis 2.0%. The incidence of significant podiatric pathology was 19.4%. (*indicates significant pathology). CONCLUSION: We found significant podiatric health issues in this high-risk population. Our data set suggests the need to include a podiatric examination as part of the contemporary care of pregnant patients with pre-existing diabetes of at least 10 years duration, to allow for education, intervention, and possible decrease in disease progression. A complete podiatric examination should be done in addition to other end organ surveillance commonly employed, such as, 24-hour urine protein, EKG, ophthalmology, and selected echocardiography.