Diabetic Foot Care

What is the role of a podiatrist in the care of diabetic patients? 

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As the specialist of the lower extremity, the podiatrist has an important role in the treatment team for patients with diabetes. Often times, the symptoms of  diabetes can manifest in the feet as numbness and tingling. This loss of sensation is called peripheral neuropathy. Podiatrists have an essential role in preventative medicine when it comes to diabetic foot care. This includes trimming thickened toenails which can cause wounds and paring down calluses before they become ulcers. Routine foot care is important for those who are considered “high-risk” for developing ulcers which may arise from lack of protective sensation and foot deformities. 

 

Today's podiatrist is an integral part of the treatment team and has documented success in preventing amputations:

• More than 100,000 lower limbs are amputated annually due to complications from diabetes.

• After an amputation, the chance of another amputation within three to five years is as high as 50 percent.

• Including a podiatrist in your diabetes care can reduce the risk of lower limb amputation up to 85 percent and lowers the risk of hospitalization by 24 percent.

 

The key to amputation prevention are early recognition and regular foot screenings performed by a podiatrist, the foot and ankle expert.

 

Why are foot wounds a concern for people with diabetes?

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People with diabetes are more likely to have nerve damage, poor circulation, and increased susceptibility to infections. Combined, these factors make treating foot wounds or ulcers more urgent and more complicated than for people who don’t have diabetes.

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If you have diabetes, wounds heal slowly but progress quickly, so when left untreated, even a small blister or wound in your foot can lead to a serious infection and, potentially, losing your foot. Nerve damage from diabetes, known as diabetic neuropathy, can cause the skin to dry and crack, leaving you more vulnerable to wounds and infections. Over time, diabetic neuropathy also leads to a loss of feeling in the foot, and because you can’t feel pain, you have to visually inspect your feet to be able to tell if you have a wound.

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When you notice a diabetic foot wound, you should see a podiatrist as soon as possible to receive treatment.

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Symptoms

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Diabetes warning signs involving the feet and ankles include the following:

• Skin color changes

• Swelling of the foot or ankle

• Numbness in the feet or toes

• Pain in the legs

• Open sores on the feet that are slow to heal

• Ingrown and fungal toenails

• Bleeding corns and calluses

• Dry cracks in the skin, especially around the heel

 

How do I prevent diabetic foot wounds?

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Successfully managing your diabetes is the best way to prevent complications, including foot wounds. Exercising and eating a healthy, balanced diet will improve blood flow throughout your body, prevent nerve damage, and reduce your risk of foot wounds.

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Regularly inspecting and taking care of your feet will keep your feet healthier and ensure you get prompt treatment for wounds when they do occur. At least once a day, you should search the bottoms of your feet and toes for signs of:

• Puncture wounds

• Bruises

• Redness

• Blisters

• Ulcers

• Cuts

• Scratches

 

To care for your feet, thoroughly wash them with soap and warm water, and apply lotion to prevent dryness and cracking. Be careful to avoid moisture in between the toes. Make sure you have comfortable, supportive shoes that allow your feet to breathe, and wear socks at all times to protect your feet from infections and the development of blisters and sores.

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Take Action

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If you have diabetes, follow these foot care tips:

• Inspect feet daily. Check your feet and toes every day for cuts, bruises, sores, or changes to the toenails, such as thickening or discoloration.

• Wear thick, soft socks. Avoid socks with seams, which could rub and cause blisters or other skin injuries.

• Exercise. Walking can keep weight down and improve circulation. Be sure to wear appropriate athletic shoes when exercising.

• Have new shoes properly measured and fitted. Foot size and shape may change over time. Shoes that fit properly are important to those with diabetes.

• Don't go barefoot. Don't go without shoes, even in your own home. The risk of cuts and infection is too great for those with diabetes.

• Never try to remove calluses, corns, or warts by yourself. Over-the-counter products can burn the skin and cause irreparable damage to the foot for people with diabetes.

• Get regular checkups by a podiatrist—at least annually—to ensure that your feet remain healthy.