Because neuroischemic complications are associated with a high rate of recurrence, we propose a slight shift in the mechanism by which we counsel and communicate risk daily with our patients. If the epidemiology of this problem is comparable with that of cancer, and recurrences are common, then perhaps language commensurate with such risks should follow. After initial healing of an index wound, our unit now refers to patients not as being cured but rather as being “in remission.” This concept is easy for the patient and the rest of the team to understand. We believe that it powerfully connotes the necessity for frequent follow-up and rapid intervention for inevitable minor and sometimes major complications. (J Am Podiatr Med Assoc 103(2): 161–162, 2013)

Lower-extremity complications of diabetes, including ulcers, infections, vascular disease, and amputation, are growing increasingly common worldwide.1  One-, 3-, and 5-year mortality rates associated with these complications are widely accepted to be equivalent to those of aggressive forms of cancer.25  Just as with cancer, the complexities associated with management of these patients has led to an increase in the proliferation of specialty diabetic foot teams.68 

A comparison with cancer therapy is apt in terms of epidemiology and, we propose, provision of care. Most people undergoing cancer therapy are best served through treatment in interdisciplinary cancer treatment centers at least for the initial stages of active therapy. So too, it seems that treatment of complex diabetic foot complications might best be served in this manner.914 

As treatment of these conditions has begun to change worldwide, we believe that the syntax associated with treatment has yet to evolve. Much as with patients with cancer, patients with diabetic foot ulcers are complex, their required treatment is multidisciplinary, and their care is optimally provided in specialty centers. Because neuroischemic complications are associated with a high rate of recurrence, we propose a slight shift in the mechanism by which we counsel our patients.15  If the epidemiology of this problem is comparable with that of cancer, then perhaps language associated with this problem should follow.16  After initial healing of index wounds, our unit now refers to such patients as being “in remission.” This concept is easy for the patient and the rest of the team to understand. Importantly, we believe that it powerfully connotes the necessity for frequent follow-up. It also prepares the patient and the clinician for inevitable minor and major complications that may occur throughout a lifetime of preventive management. We look forward to further works in this area adopting or modifying this theme.

Financial Disclosure: None reported.

Conflict of Interest: None reported.

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