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Putting Your Best Foot Forward with Diabetes Care

  • Category: Articles by Clinicians
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  • Written By: Martin Johnson, MD, MPH, Casa Colina Hyperbaric Medicine and Wound Care Center
Putting Your Best Foot Forward with Diabetes Care

One of the first questions I ask a patient with a diabetic foot wound is: Do you like having feet?

It’s blunt, but it gets their attention. And it should. According to the nonprofit Amputee Coalition, 85% of lower-limb amputations begin with one of these pesky wounds. Diabetic foot ulcers heal slowly and are prone to infection, mostly due to neuropathy, or loss of sensation in the feet. Diabetes not only causes the numbness that prevents you from feeling these wounds worsen—it also throws the autonomic nervous system out of whack, so your feet generate less oil and sweat. They become more prone to cracking and, hence, problematic wounds. It’s a vicious cycle that affects most diabetics.

All told, diabetes contributes to 80% of the 120,000 non-traumatic amputations performed annually in the United States. About half of individuals who lose a limb due to diabetes will have the other limb amputated within two years. Even scarier is the five-year mortality rate for diabetic lower-limb amputees, which averages above 50%—second only to rates for pancreatic and lung cancers.

So obviously, if you have diabetes, you need to care for your feet! Quitting smoking, eating healthy, and exercising will help to maximize circulation to your feet and minimize further nerve damage. Keeping your blood pressure, cholesterol, and body weight in check will increase your net benefit here.

But you can be even more proactive. Self-administered diabetic foot exams are easy and quick—just ask your doctor how to perform one. Healthcare providers like Casa Colina also offer free monthly foot health screenings. You might consider requesting referral to a podiatrist, who can further evaluate your feet. Keeping your feet clean and moisturized, your toe nails trimmed, and wearing well-fitting shoes are also great ways to protect your feet.

If you develop a foot ulcer, don’t panic. Ask your doctor for referral to a physician specializing in wound care. This doctor may prescribe certain dressings—such as a podiatric felt pad or total-contact cast—that relieve pressure off the wound. Relieving that pressure allows new blood vessels to develop and new tissue to form, which in turn allows for wound closure.

As always, the ideal approach is preventing that wound before it happens! Stay proactive with your diabetes care and see a healthcare provider at the first sign of a foot wound—your feet will thank you.

Casa Colina Hospital and Centers for Healthcare hosts free monthly foot health screenings at both its Pomona and Azusa locations. For patients who require medical care for a foot wound, the Casa Colina Limb Preservation Program offers comprehensive services including podiatric surgery, wound care, diagnostic imaging, hyperbaric and physical therapies, and state-of-the-art surgical services. To register for a screening, or for more information, call 909/596-7733, ext. 3039.