Columbia VA podiatrist recognized for diabetes-related amputation research

Dr. Brandon Brooks, a podiatrist at Columbia VA, earned first place at the 10th Annual Conference of the American Society of Podiatric Surgeons for his abstract: "DREADD: Diabetes-Related Extremity Amputation Depression & Distress."

This achievement marks his third consecutive first place win in national abstract competitions, solidifying his reputation as a leader in podiatric research focused on improving care for Veterans.

The winning abstract introduced DREADD, a term coined to describe the emotional and psychological toll experienced by patients following any diabetes-related amputation.

The study focused on "minor, non-traumatic" amputations, such as the loss of a toe. While these procedures are often viewed as relatively minor from a surgical perspective, Brooks' research reveals that they can have significant psychological consequences among patients with Type 2 Diabetes Mellitus.

His study found that 90% of patients experienced increased depressive symptoms following an amputation. For many, the loss of even a small part of the body is a deeply emotional and traumatic event. This distress can impact their overall health outcomes, leading to issues such as medication non-compliance, missed appointments and poor dietary choices.

Depression can make it harder for patients to manage their diabetes

The study highlights a bidirectional relationship between depression and Type 2 Diabetes Mellitus, meaning that one condition often worsens the other. Depression can make it harder for patients to manage their diabetes effectively while poorly controlled diabetes can increase the likelihood of complications, including amputations.

By understanding this cycle, health care providers can better address the full scope of a patient's needs.

"It's important to recognize that a 'minor, non-traumatic amputation' can still be a traumatic experience for a patient," Brooks explained. "I believe this study will encourage multidisciplinary limb preservation teams to consider mental health clinicians, such as but not limited to psychiatrists and clinical psychologists as team members."

Brooks emphasized the importance of early intervention, recommending that clinicians use validated tools like the PHQ-9 to screen patients for depressive symptoms following an amputation. This step allows health care teams to identify those at risk and provide timely referrals to mental health professionals, ensuring patients receive comprehensive care.

Brooks' brother, Bradley, is a board-certified psychiatrist and co-author of this study, making the brothers' collaboration unique aspect of this project. Brooks described their collaboration as a seamless blending of perspectives. Bradley also contributed the acronym DREADD, which captures the distress many patients feel following an amputation.

Model could improve surgical outcomes

The study advocates for including mental health professionals, such as psychiatrists and clinical psychologists, in multidisciplinary limb preservation teams. This approach ensures patients receive both physical and emotional support during their recovery. Brooks noted that this model could improve surgical outcomes by addressing the mental health challenges that often accompany physical trauma.

Brooks attributed much of his success to the supportive research environment at Columbia VA. He highlighted the flexibility and resources available to researchers, including access to ethics guidance, quality improvement opportunities and encouragement from leadership.

"Dorn [the Dorn Research Institute] is a great place for research," Brooks said. "The culture here fosters innovation and allows us to push boundaries to improve care for Veterans." At the heart of his work is a deep commitment to the Veterans he serves. He views his research as an extension of his dedication to improving their quality of life.

"It's an honor and privilege to care for our Veterans. They inspire me every day, and I want to do everything I can to help improve their outcomes," he added.

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