Common Foot and Ankle Conditions We Treat

Diabetic & AT-Risk Feet

Diabetes, Peripheral Neuropathy, Peripheral Arterial Disease, At-Risk Feet, Swelling of Foot, Ankle and Leg, Ulcers
Diabetic and At-Risk Feet

Diabetic & At-Risk Feet

High blood sugar over time can lead to complications in the feet, resulting in damage to blood vessels and nerves.    Damaged blood vessels result in poor healing and damage to nerves leads to neuropathy (numbness, tingling, burning), which is the number one risk factor for developing a foot ulcer in diabetics.

As Benjamin Franklin once said “an ounce of prevention is worth a pound of cure.”  Such is the case with diabetes and your feet.  By following a few simple steps, you can prevent complications, some of which if left untreated, can lead to amputation.

  • Inspect your feet daily, in between the toes and on the bottom of both feet. If you cannot see the bottoms of your feet, use a mirror or ask someone for help.
  • Call our office if you notice cuts, blisters or breaks in the skin, redness, swelling, drainage or have an ingrown toenail.
  • Call our office if you notice foot changes like color, shape, skin temperature or pain.
  • Maintain good blood sugar control.
  • Keep your skin soft and smooth. Rub a thin coat of moisturizer over the tops and bottoms of your feet, but not in between your toes.
  • Wear shoes and socks at all times. Never walk barefoot. Wear comfortable shoes that fit well and protect your feet. Check inside your shoes before wearing them. Make sure the lining is smooth and there are no objects inside.

Diabetic & At-Risk Feet

Peripheral neuropathy occurs when the nerves outside of the brain and spinal cord are damaged.  One of the most common causes of peripheral neuropathy is diabetes.  Other causes include: infection, trauma, alcoholism, vitamin deficiency and metabolic disorders.  Some signs and symptoms include burning, tingling, numbness, weakness, loss of balance, feeling as if you are wearing socks when you are not and sharp pain.

Because there is no cure for neuropathy, the goal of treatment is to manage the condition causing the neuropathy and to relieve symptoms.  In some cases, topical and oral medications are prescribed. 

Peripheral neuropathy associated with diabetes is directly related to blood sugar control.  The higher the blood sugar levels, the greater the chance for nerve damage.  Although diabetic nerve damage can sometimes cause pain, it can also lessen your ability to feel pain, heat, and cold. Loss of feeling often means you may not feel a foot injury. You could have a tack or stone in your shoe and walk on it all day without knowing. You could get a blister and not feel it. You might not notice a foot injury until the skin breaks down and becomes infected.

Diabetic & At-Risk Feet

People with diabetes, peripheral neuropathy and arterial disease can develop many different foot problems. Even ordinary problems can get worse and lead to serious complications.

It is important to look for changes in the skin of your foot.   If the skin is too dry it may peel and crack.  Calluses and corns, if not trimmed, get very thick, break down, and turn into ulcers (open sores). Never try to cut calluses or corns yourself – this can lead to ulcers and infection. Let our podiatrist trim your calluses and corns.  Avoid using over-the-counter callus and corn pads with chemical agents. These products can burn your skin.

Diabetic & At-Risk Feet

An ulcer is a wound (open sore) that won’t heal or keeps coming back.  There are three main types of leg and foot ulcers: Venous stasis, Neuropathic, and Ischemic. 

Ulcers are common in patients with leg swelling/varicose veins, poor circulation, diabetes, neuropathy and peripheral arterial disease. Open wounds put people at an increased risk of developing infection in the skin and bone. 

Signs and symptoms to look for include: drainage, foul smell, redness and swelling. Pain may or may not be present.

Healing of an ulcer can be delayed in the presence of one or more of the following: infection, poor circulation and pressure.  Wound cultures, X-rays and sometimes advanced imaging studies, such as MRI and bone scan, are used to evaluate for infection.  Noninvasive vascular testing is utilized to evaluate for underlying vascular disease.  Offloading of ulcers can be accomplished with padding, special shoes, boots or casts.

Treatment of ulcers includes removing dead or infected tissue and performing local wound care.  If ulcers involve extensive infection or are slow to heal, surgery or other advanced wound care treatments, such as skin grafting, may be necessary.