The Role of the Podiatrist-Diabetes

Diabetes is a chronic disease that affects over six percent of the population. This number can be even higher in the elderly population. One of the most common complications of the disease is problems with the lower extremities and the feet. If you have been diagnosed with diabetes, a podiatrist can be a crucial member of your health care management team.

Diabetes and Complications in the Lower Extremities

The feet and lower extremities are at risk for diabetes complications due to damage to the nerves, poor circulation, infection, and other diabetes related issues such as kidney disease.

As a diabetic, your pancreas is not producing the insulin necessary to keep your blood sugar levels in balance. Your pancreas may be secreting too little insulin or no insulin at all. When this occurs, your blood sugar levels can become elevated.

Over time, this decrease in insulin production, and the resulting fluctuation in blood sugar levels, may lead to damage in the nerves. Doctors call this condition peripheral neuropathy. A person who has peripheral neuropathy loses sensation in lower extremities and the feet.[1]

The decrease in insulin production can also lead to poor circulation. Poor circulation does not allow wounds to heal quickly or properly and can lead to ongoing problems for diabetics. In addition, poor circulation can leave diabetics at a higher risk to infection in the feet and lower extremities, especially if they have an open wound or sore.

Kidney disease is another complication associated with diabetes. It can interfere with the feet. The proteins produced by the kidneys are involved in healing wounds and sores. When kidney disease is present, these proteins are not available to help heal any problems in the lower extremities and feet.

Due to this diabetes related complications, the following consequences often occur:

  • You may have a sore or wound on your foot and not know it because of peripheral neuropathy – you do not feel the sore. For example, you may wear a shoe that rubs a blister on your foot and you would not feel the blister.
  • Blisters, sores, and wounds on your feet may not heal due to poor circulation. Foot ulcers can easily develop. Plus, infections can spread from the feet other parts of the body.

The Podiatrist

As a diabetic, it is vital to have a podiatrist on your heath care team. A podiatrist is a doctor who specializes in podiatric medicine. In addition to his or physician’s or surgeon’s credentials, a podiatrist has continued training in conditions and diseases of the feet and the lower extremities.

It is important to visit your podiatrist soon after you get a diagnosis. You and your podiatrist will work together to develop a self-care program for your feet, and you will schedule regular office visits for podiatric foot care.

During your office visits, the podiatrist will perform a physical exam of your feet. He or she will look for any signs of sores, wounds, or diabetic ulcers. If you have had any signs of these problems at previous visits the podiatrist will check to see if they are healing and if further treatment is necessary. You will have your nails trimmed and your doctor will answer any questions you may have.

Self-Care

You and your podiatrist will discuss a program of self-care. This is essential to good foot health and will lessen your chances of diabetic related foot complications.

Your podiatrist will encourage you to:[2]

  • Inspect your feet every day for signs of blisters, wounds, or ulcers
  • Wash your feet every day
  • Wear cotton socks
  • Never go barefoot
  • Wear properly fitted shoes
  • Wear shoes with low heels, rounded toes, and plenty of room

Your podiatrist will also encourage you to exercise every day. While exercise is great for your overall health, it is extremely important for the health of your feet and your lower extremities. As a diabetic, daily exercise will help you stimulate the flow of blood to your feet. This will lower your risk for nerve damage and increase your circulation.

You can expect to visit your podiatrist several times a year. Establishing a good relationship with your doctor and following a self-care plan will greatly lower your risk of diabetes compilations in the feet and lower extremities.

References

[1]  Working Together to Manage Diabetes. (n.d.). Retrieved from National Institute of Health: http://www.ndep.nih.gov/media/PPODprimer_color.pdf

[2]  Prevent Diabetes Problems: Keep Your Feet and Skin Healthy. (n.d.). Retrieved from National Institute of Health: http://diabetes.niddk.nih.gov/dm/pubs/complications_feet/#doctor

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