Patient Care

Health Equity Spotlight: Addressing Disparities in Diabetic Foot Infections

Jan. 22, 2024

Nearly 2 million Americans with either type 1 or 2 diabetes develop a diabetic foot ulcer (DFU) each year. Infections complicate about 40% of all DFUs, and more than 50% of admitted patients with DFUs undergo an amputation within a year.

Members of UR Medicine’s Vascular Surgery and Infectious Diseases divisions decided to explore our health system’s race and ethnicity data to see how treatment and clinical outcomes differ among patients with DFUs. National studies show that when compared to their white counterparts, Black patients with DFUs may be more likely to:

  • Present with chronic limb-threatening ischemia
  • Undergo primary amputation rather than revascularization or limb-sparing procedures, such as toe amputations or tissue debridement
Dr. Alexandra Yamshchikov
Alexandra Yamshchikov, M.D.

UR Medicine's Vascular Surgery division participates in the regional and national Vascular Quality Initiative (VQI) network to share and further analyze vascular surgery data to improve outcomes, develop quality initiatives to standardize processes, etc. According to Alexandra Yamshchikov, M.D., a UR Medicine Infectious Diseases physician, having accurate documentation of race and ethnicity creates further opportunities for clinical providers and staff to examine these differences with an equity lens. “We have to start somewhere,” said Yamshchikov. “Having accurate race and ethnicity data gives us the chance to de-aggregate this information to see areas where interventions may be needed.”

In terms of interventions, Yamshchikov believes focusing on clinician-patient interactions is key. “Clinicians can continue to play a critical role by making sure all patients have access to services, and ensuring we’re prescribing and referring patients to those services in an equitable manner” said Yamshchikov.

Before interventions can take place, Yamshchikov stresses the importance of first leveraging accurate data. “Data is a tool,” said Yamshchikov. “Good tools allow us to do good work.”