Diabetic Foot Problems- The Podiatrist

Diabetics are in a high risk category for developing wounds and severe complications in their lower limbs and feet. If you have been diagnosed with diabetes you should take precautions to ensure the health of your feet and lower extremities.

Working with your diabetes healthcare management team is of primary importance. A podiatrist is avital member of this team. It is a good idea to establish a relationship with a podiatrist early in your diagnosis in order to lessen your chances of wounds and infections that can lead to amputations.

Diabetes and Your Limbs

Over one thousand limbs are amputated every year due to diabetic complications. Diabetes can cause problems throughout your body, including the lower limbs and the feet.

How does diabetes affect your lower limbs and feet? Your pancreas naturally produces insulin. Insulin, a hormone, is utilized by the body to regulate blood sugar. If your pancreas secretes too little insulin, you will have elevated blood sugar levels. This is also true if your pancreas produces no insulin or is not very effective at producing insulin.

Decreased insulin production, left untreated, will eventually lead to damage in the blood vessels and nerves. It can hinder the flow of blood in the lower limbs and to your feet. This can result in nerve damage, called peripheral neuropathy, (numbness in your feet). Reduced blood flow in your lower extremities can also lead to undetected abrasions, cuts, and wound.

In serious cases, the reduction of blood flow to the legs and feet of diabetic patients can result in peripheral arterial disease.[1] With this disease your tissue does not heal, and the result is often amputation of the foot.

The Podiatrist

A podiatrist is a physician or surgeon who specializes in podiatric medicine. He or she has extensive training in the area of diseases and conditions that are commonly found in the feet, the ankles, and the leg.

Your first visit to the podiatrist will involve a medical history and a physical exam. You and your podiatrist will discuss the current health of your feet and lower extremities. Together, you will work toward developing a healthy management plan for these areas.

You will visit your podiatrist for regularly scheduled appointments. During these appointments the following diabetic foot care procedures may be performed:

Nails: It is important to have your nails trimmed by a trained professional. This will help you avoid ingrown toenails and thick nails.

Blisters and Sores: Your feet will be examined for sores and blisters. If caught early, ulcers can often be prevented.

Physical Exam: At each appointment you should expect a physical exam of the feet to ensure there are no new wounds and to determine how previous blisters or wounds are healing.

At-Home Care

Some of the most helpful information you take away from your meetings with your podiatrist will be the ‘at-home’ care suggestions. These suggestions will allow you to care for your feet in your own home and should be followed on a daily basis.

Common suggestions from podiatrists for at-home care include:

Daily Inspection of Your Feet: Your podiatrist will teach you to look for cuts, blisters, and wounds that are not healing. He or she will also teach you to look for the beginning signs of wounds.

Shoes: Your podiatrist will instruct you in the importance of properly fitted shoes. Many podiatrist offer custom shoes or insoles designed for diabetics. These shoes and insoles help relieve pressure points that can lead to wounds.

Wear Shoes at All Time: You will be instructed to always wear shoes. Walking barefoot can lead to wounds, especially if you have diabetic neuropathy and do not have feeling your feet.

Cotton Socks: You will learn that cotton socks, and socks that wick away dampness, are best for diabetics. Specialized socks are manufactured for diabetics. These socks do not have a seam and therefore do not put pressure on the foot when wearing shoes.

Exercise: You will be urged to exercise daily. Daily exercise will help stimulate the blood flow to your lower extremities. It will help your overall diabetes health as well.

Most importantly, you are urged to have annual foot screenings. Studies reveal that patients with problems in their lower extremities, who see a podiatrist, are at a much lower risk of losing a limb than diabetics with similar problems who do not seek the help of a podiatrist.[2] Your podiatrist may want to see you in his office more than once a year if you have issues with your feet that need to be addressed.

References

[1] Management of Diabetic Peripheral Neuropathy. (n.d.). Retrieved from Clinical Diabetes: http://clinical.diabetesjournals.org/content/23/1/9.full

[2]  Fact Sheet. (n.d.). Retrieved from American Podiatric Medical Association: http://www.apma.org/files/FileDownloads/TRH-Duke-One-Page-Summary.pd

This article was originally published July 12, 2012 and last revision and update of it was 9/10/2015.