The Diabetic foot has a great socio economic impact in our society. Diabetes is elevated blood sugar due to lack in production of insulin. This leads to medical conditions such as Foot Ulcers/Neuropathy/Arterial disease/Cardiovascular problems/Renal failure. A diabetic patient can develop neuropathy which is a decrease in sensation due to damage to the nerves. This can cause pain and lead to foot ulcers. Foot ulceration leads to major foot amputation.
Diabetic Foot Care:
- Daily Foot Check
- Performing daily foot checks to look for new ulceration lesions. With diabetes, patients lose both the elasticity and feeling in their skin.
- Supportive shoe gear
- It is extremely important for diabetic patients to wear good supportive shoe gear with accommodative insoles. This helps to evenly distribute the pressure and prevent lesions/ulcers from happening.
- Monitoring Blood sugar
- Elevated blood sugar is directly linked with weight gain, heart failure, and neuropathy. Making sure your diabetes is managed is a key component to overall health. Patients should work with their Primary care physician and to check their HGA1C (measurement of blood sugar over a 3 month period).
- Wound care
- Patients with wounds & ulcerations are at a very high risk of limb loss. Maintaining a healthy wound base and proper offloading is key to wound healing. At laser foot surgery centers we carry amniotic grafts which can accelerate the rate of wound closure preventing expensive surgery and long term antibiotic use.
- Neuropathy is the loss of sensation due to damage to the nerves. Elevated blood sugar levels can lead to nerve damage. Patients will complain of burning tingling and shooting pain, especially at night. Diabetic who have neuropathy can form cuts, blisters and pressure sores due to a lack of sensation in their feet. If these wounds are left untreated the can lead to bone infection/amputations and other deformities (bunions, hammer toes, charcot feet)
- Elevated blood sugar leads to the calcification of the arteries (bring oxygenated blood to the foot). Calcification leads to decreased blood flow to the feet. Patients will complain that their feet feel cold or cramping in their legs after walking (intermittent claudication). Blood flow is necessary to heal any opening and lesions. Patients with poor blood flow have problems walking, healing ulcerations. They are at very high risk for limb loss/amputations.
Treatment and Preventative measures
- Early treatment of diabetic ulcers is key in healing open wounds and lesions
- Going to your podiatrist for diabetic foot care is critical in preventing amputation and infections
- Diabetic shoes with a wide toe box
- Plastisol inserts
- These inserts are accommodative insoles that will identify pressure areas.
- They will then offload these pressure areas preventing ulcerations from forming
- For patient with severe foot deformities patient may require special bracing
- Daily blood sugar monitoring.
- Wound care dressing changes and offloading to help ulcerations heal faster.