Helping patients achieve their best below-the-knee health, Foot & Ankle Surgical Associates (FASA), manages and treats many chronic conditions related to the foot and ankle, including diabetes. A condition that affects millions of Americans, patients with diabetes often require regular foot care. FASA offers a range of diabetic foot services, from routine diabetic foot examinations and diagnostic tests to surgical procedures.
Diabetes is a disease that arises when blood sugar levels are too high within a patient’s body. Because the cause of high blood sugar can vary, diabetes is split into Type 1 and Type 2. Comprising of about 5-10 percent of the diabetic population, Type 1 diabetes occurs when a patient’s body doesn’t produce enough insulin. A more common condition, Type 2 diabetes occurs when a patent’s body doesn’t respond well to insulin. In a patient with Type 2 diabetes, insulin remains in the bloodstream and can lead to higher A1C levels, which can cause complications throughout the body, including in the foot and ankle.
FASA provider, Dr. Casey Bowles, says that although diabetes itself does not result in foot and ankle problems, complications from diabetes can affect the foot and ankle. For patients who have well-controlled diabetes, the risk of complications is low. But if diabetes is left untreated or is poorly treated, several conditions can arise, including nerve damage and circulation issues in the foot and ankle. Peripheral neuropathy, a form of nerve damage, is a potential complication of diabetes and can result in a numb, tingling, or burning sensation in the foot. If a diabetic patient has neuropathy or circulation problems, they may be at a higher risk for foot infections that require surgical treatment.
“If a person can’t feel their foot, that is a huge deal and is a reason why diabetics end up losing toes or face amputations,” explains Bowles. “It is because they get a small sore or cut that doesn’t heal, they don’t know that they have it, and the cut ends up getting infected. By the time the patient notices it, it’s too late and we have to start doing surgery to fix those things.”
To help prevent serious complications, Bowles encourages diabetic patients to manage their diabetes and maintain healthy blood sugar levels. A daily at-home foot exam is also recommended, to screen for potential abrasions that can become infected.
“The most important thing is to inspect your feet daily,” says Bowles. “Check for any cuts, sores, and things like that. Any swelling or ingrown toenails, which can cause infection. Corns and calluses are very important to look at, because those can be hiding ulcerations and signifies that they are having extra pressure where the callus is. Check for any fungus or athletes’ foot. And if you walk or are an active person, you should check your feet twice a day.”
Patients should also wash their feet in lukewarm water when bathing, and moisturize regularly to help prevent dry, cracked skin. Bowles says patients who have nerve damage and cannot feel their feet should not cut their own toenails and instead, should visit a medical professional for regular nail care. Bowles also advises against any at-home removal of foot corns or calluses and recommends that patients visit a medical provider for proper treatment.
Another important way to prevent serious complications is to wear clean, dry socks at all times and to never walk barefoot. Foot protection, even indoors, can help prevent scratching, irritation or puncturing of the skin. Depending on the patient, compression socks may also be recommended to help with blood flow in the foot and ankle.
For patients with diabetes, FASA offers an array of diabetic foot services to help prevent and manage potential complications. Paired with at home-foot inspections, FASA providers also conduct routine diabetic foot examinations. “Foot checks are a very important thing to do, particularly if you are diabetic with neuropathy,” says Bowles. “It’s good to have someone else check your feet instead of yourself, just to make sure things are going okay.”
FASA provides in-office x-rays and a variety of diagnostic tests to help screen for circulation problems, including PADnet testing, which screens for peripheral artery disease. FASA also schedules diabetic shoe fittings, which can help further protect a patient’s feet. “We do custom shoes here in office,” he adds. “Which is another important thing for diabetics, because if they don’t wear the proper size or proper shoe, it leads to wounds and ulcerations.”
In addition to routine foot care, Bowles also recommends that patients should see a doctor if they are experiencing any unusual changes to their foot or ankle. This can include cramping, burning, pain, numbness or tingling in the foot. Foot changes can also include loss of hair, which can mean an issue with circulation. Bowles also says that conditions like dry, cracked skin, wounds, temperature or color changes in the foot are also reasons to see a doctor.
“The diabetic patient is their first line of defense on keeping their feet in good shape,” says Bowles. “It’s important to be aware of your feet. I always tell people, if you notice anything that is out of the ordinary, looks weird or doesn’t look normal, make sure to come in and see a doctor as soon as possible because a little thing can turn into a big problem really fast for a diabetic. And of course, it is important to keep your own good health by walking, and keeping your blood sugar down.”
To learn more about the diabetic foot cares services offered by FASA, visit the Foot & Ankle Surgical Associates website.