Living with diabetes requires careful attention to your body to keep your health optimized and prevent the many complications of this disease. Diabetes can damage many organ systems in the body but can be particularly destructive on the eyes, kidneys, and feet.
Foot care is an essential part of a comprehensive diabetic treatment plan, but this involves more than just visual inspection of the feet for problems. It includes assessing and monitoring blood flow, nerve health, bone health, and skin condition to help prevent potentially devastating problems in the future.
Dr. L. David Richer and our staff at the Foot, Ankle & Leg Center have a comprehensive approach to diabetic foot care. We have the resources and technology to assess for underlying problems and are happy to serve as part of your overall diabetic care team.
How Diabetes Can Affect Your Feet
Diabetics who do not keep their blood sugars under control tend to have more frequent and more severe complications from their condition. Even diabetics who are well-controlled can suffer from vascular, neurologic, orthopedic, and dermatologic complications of the feet.
The feet might not initially seem like a prime target for the effects of diabetes, but several complications can occur.
- Vascular complications: Circulation to the feet can become impaired or blocked. It is already somewhat of a challenge to have blood reach our feet compared to other parts of our body, simply due to our feet being the body part furthest from our heart. As diabetes damages our blood vessels, the feet tend to be the first body part to suffer. Restricted or reduced blood flow to our feet means our cells have less oxygen, nutrients, and healing factors required for repair and maintenance. This is called peripheral arterial disease, or PAD, and means injuries to your feet can take longer to heal. In severe cases, a wound might not heal at all without improvements in the blood flow to the foot.
- Neurologic complications: Diabetes can damage the nerves in your feet and legs, also known as neuropathy. As the nerves deteriorate, they are unable to properly transmit signals of sensation (pressure, vibration, temperature, and pain) to the brain. This might first result in tingling or pain but can eventually result in numbness. NEUROPATHY AND PAD IS A VERY DANGEROUS COMBINATION! When numbness is severe enough that you do not feel an injury on your foot and it does not hurt, you will continue to put weight on it and further damage the tissue. Due to the reduced blood flow, the injury is unable to repair itself. Frequently because it does not hurt and/or goes unnoticed, treatment is delayed. This can result in a wound or ulcer that becomes infected and may progress to the point where an amputation is required.
- Orthopedic complications: Walking on a numb foot due to diabetic neuropathy can cause the foot and ankle bones to weaken and fracture, called Charcot arthropathy. This can result in improper alignment of the bones in the feet or a misshapen foot which can be prone to developing wounds or ulcers, often on the soles of the feet.
- Dermatologic complications: Ulcers or wounds on the skin of the feet can occur in diabetics who have neuropathy and/or bony deformity to the feet. These wounds are prone to infection, especially if not cared for.
Our office can provide thorough treatment for diabetic wounds, but we also wish to help our patients avoid them in the first place.
Our Diabetic Foot Care Services
We focus on both immediate and preventative care for all our diabetic patients.
If you have already been diagnosed with diabetes, we recommend regular evaluation of your circulation, nerve health, bone health, and skin condition as it relates to your feet. We perform this evaluation in-office through:
- A comprehensive evaluation of your feet, including your shoe gear.
- Ankle-brachial index (ABI) testing to check for peripheral artery disease (PAD) and other circulatory issues.
- Epidermal nerve fiber density testing to assess the severity of neuropathy.
- Examination for nerve entrapment or pinched nerves which may be causing, or worsening, the neuropathy.
- Radiographs (x-rays) of the feet and ankles
- MLS laser therapy for treatment of diabetic neuropathy to restore normal sensation to the feet and legs and eliminate pain
Frequent foot evaluations for diabetics can assess for vascular, neurologic, orthopedic, and dermatologic problems. The American Diabetes Association recommends at least annual foot evaluations by a podiatrist. More frequent evaluations will be recommended if you have suffered complications of diabetes affecting the feet.
It is also very important that you visually inspect your feet daily for signs of trouble and let us know when you find problems. We can help you determine what to look for specifically and how to respond to it.
We may also recommend changes in exercise routine, diet, and footwear. Diabetic shoes are specially made to accommodate diabetic feet and reduce the chances of sores and other injuries. We may recommend a special diabetic insole or orthotic to help protect high-risk feet from pressure problems.
If wound care is needed, you are in good hands. We can perform most wound care in-office and have a wide range of advanced treatments available. These include amniotic products, growth factors, and skin substitutes. We can even take a sample of a patient’s own skin to create a natural graft if needed.
Diabetic Foot Care Starts Now
Even if your feet feel fine at this point in time—and we hope they do—there is no time too soon to have a thorough evaluation and begin preventative diabetic foot care. The attention you pay to your feet now may very well prevent future complications.
Conveniently schedule and appointment online, complete the contact form, or call (480) 629-5903 to schedule an appointment with Dr. Richer. From our well-appointed office in Scottsdale, we serve patients throughout the Phoenix area, including Paradise Valley and Fountain Hills.