Evidence & Outcomes
Evidence-Based and Outcomes-Driven
Grounded in peer-reviewed research and national diabetes standards.
This initiative is supported by two major sources of peer-reviewed evidence demonstrating
its effectiveness in reducing diabetic foot complications and preventing limb loss.
- Five-Year City of Hope Limb Preservation Study
Peer-reviewed and published in the
Journal of the American Podiatric Medical Association (August 2025)
Journal of the
American Podiatric
Medical Association
Ref : P. Han August, 2025 JAPMA. In press A Novel Diabetic Limb Preservation Initiative-Integrated Symptom-Focused Patient Education and Strategically Coordinated Podiatric Care to Reduce Diabetic Foot Ulcers and Amputations
Ref : P. Han, J Giurini JAPMA Aug 2025 in press “Reducing Costs and Disparities: A Value-Based Economic Model for Diabetic Limb Preservation in Federally Qualified Health Centers(FQHC)”
This initiative is supported by five years of investigator-led research conducted by Dr. Han at the Department of Diabetes at City of Hope and published in peer-reviewed journals.
Reported results included a 2.8% diabetic foot ulcer incidence—representing a 32% reduction compared with national benchmarks—and a 0.43% major amputation rate, exceeding the Healthy People 2030 target of a 33% reduction established by the U.S. Department of Health and Human Services (see diagram).
These findings were associated with improved patient engagement through symptom-focused diabetic foot education and earlier detection of foot complications.
2. 2025 ADA Standards of Care
ADA FootCare guidelines authored by Dr. John Giurini
The American Diabetes Association’s 2025 Standards of Care reinforce:
- The national consensus for early identification
- Podiatry-driven interventions to prevent limb loss
- Best-practice guidelines that align fully with this program’s design
Ref : ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, Collins BS, Gibbons CH, Giurini JM, Hilliard ME, Isaacs D, Johnson EL, Kahan S, Khunti K, Leon J, Lyons SK, Perry ML, Prahalad P, Pratley RE, Seley JJ, Stanton RC, Sun JK, Gabbay RA. 12. Retinopathy, Neuropathy, and Foot Care : Standards of Care in Diabetes-2025. Diabetes Care. 2025 Jan1;48(Supplement 1):S252-265. On behalf of the American Diabetes Association. Diabetes Care. 2025”