Diabetic Foot Care: Preventing Amputations

I've learned from reading all of your comments how concerning it is to be diabetic and see all these amputations. I want to assure you that amputations do not happen overnight. And it doesn't just happen because of diabetes alone. Often times there are early clues and many situations are easily corrected. Here's an example:

 A callus builds up pressure causing the skin to break down. Shaving this down regularly and wearing appropriate diabetic shoes can prevent this callus from becoming an ulcer. Open wounds or ulcers are beginnings infections and amputations. Let's prevent that!

A callus builds up pressure causing the skin to break down. Shaving this down regularly and wearing appropriate diabetic shoes can prevent this callus from becoming an ulcer. Open wounds or ulcers are beginnings infections and amputations. Let's prevent that!

A long time diabetic patient presented for her first diabetic foot check. She states walking a lot at home, cooking and doing housework often wearing no shoes. She's developed a callus but doesn't see the podiatrist until "it really hurts." Unfortunately, she has the late stages of diabetes that affects the nerves in the feet, so she has some numbness as well. She is older too so cannot bend over to see the bottom of the feet and has blurred vision so cannot see clearly. 

Can you see how all of the combined issues in this case make this particular patient more vulnerable to foot infections? How so, you ask?

1. Having diabetes "for a long time." As soon as you are diagnosed with diabetes, you should see a podiatrist right away. Foot specialists can tell you what your particular risks are and make recommendations. It could be as simple as caring for dry cracked feet, foot fungus or more serious like having a prior amputation. 

2. Only waiting to see a doctor until it really hurts. The problem with this philosophy of waiting until it gets really bad is this, it's probably really bad. Prevention is key. I repeat, PREVENTION IS KEY. I have patients deathly afraid of doctors so when they finally get to me, well I only have bad news for them. The good news is podiatrists, myself included, are very diligent about preventing any level of amputation. We are on your side. Do not be afraid. And if you are afraid of one podiatrist, there are other, many thousands of others.

3. Numbness in the feet. This is the number one reason why many patients delay care. They simply do not feel a problem because they have neuropathy. Without the gift of pain, one does not know they are walking on a thumb tack or other sharp object and overtime this gets ignored, infected and you can imagine the domino effect. 

4. Not being able to see. Our older patients simply cannot see due to diabetic retinopathy (eye damage). So it will be difficult for them to report any problems if they cannot feel or see their feet.  

I hope to prevent as many amputations as I can but I can't help if I don't know who you are. Keep sending me your questions! Thanks for reading.