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Diabetes and Your Medical Team

Posted on May 31, 2016

Diabetes is a very complicated and multifaceted disorder. Therefore, in order to manage your diabetes and learn how to make necessary lifestyle changes to control the disease, it is critical that you have a diabetes management care team in place. This team consists of your primary care physician (team leader), podiatric physician, dentist, ophthalmologist/optometrist, registered dietitian/nurse, and you! In this article, let’s focus on two key members of your care team: your podiatrist and you!

The reason it is important to have regular visits with your podiatrist is that 15–25 percent of all diabetic patients develop a foot wound or ulcer in their lifetime. Once an ulcer develops, your feet are at high risk for re-ulceration, which also puts them at high risk for uncontrolled infections and possibly amputation(s). A podiatrist is specially trained to manage potentially life-threatening foot and leg wounds and infections to avert the possibility of amputation. However, even more important is the podiatrist’s role in preventing the development of a wound on your foot in the first place.

Several studies have shown that seeing your podiatrist for regular, comprehensive, diabetic foot exams and risk assessments can reduce amputation rates by 45–85 percent. Your podiatrist will examine your feet for evidence of poor skin nutrition, poor circulation, loss of sensation or numbness, or foot deformities that are causing areas of increased pressure, which all create a risk for ulceration. Your doctor will also inspect your shoes and socks, looking for areas of increased pressure or ill-fitting shoes that are causing rubbing or blistering. Your doctor may recommend appropriate shoes, either over-the-counter or custom-made prescription shoes, or may design appropriate offloading of high-pressure areas. In certain circumstances, your podiatrist may recommend preventive surgery to correct a deformity that may be causing a high risk of future ulceration.

Perhaps the most important member of the diabetes management team is you! There are many things you can do at home to help manage your diabetes, such as:

  • Following recommendations and medication regimens prescribed by your doctor to control blood sugar levels.
  • Following good nutrition daily—incorporating education from a dietitian or nutritionist is critical!
  • Daily exercise—as little as 20 minutes of walking each day can make a difference.
  • If you use tobacco—quit! Tobacco use increases your risk for nerve and circulation damage.

More specific to your feet, there are many things you can do between podiatrist visits to prevent or detect foot wounds or infection. The most important thing you can do is simply inspect your feet daily. Make a habit of checking your feet at the same time every day, whether before or after a shower or before bed. If you are unable to see the bottom of your feet, you should have a friend or family member assist you, or get a small mirror to help you see all parts of your feet and legs. Wash your feet daily, and carefully dry thoroughly between the toes. Look for cuts and bruises that are slow to heal; tingling or numbness in hands and feet; itchiness; rashes; redness; swelling; blisters; calluses or corns; excessively wet or dry cracking skin; skin that is cold or hot to the touch; change in the shape of the feet; change in the color of the skin; thick, discolored toenails; loss of hair on toes, feet, or legs; and foot or leg cramping while walking or at rest.

It is also important for you to inspect your shoes before putting them on, looking for holes or tears in the lining, making sure there are no foreign objects in the shoe, and making sure your shoes are dry inside. You should also wear clean, dry socks every day and check your socks for holes or bloodstains. Do not walk barefoot or wear open-toed shoes or flip flops, especially outdoors or on hot surfaces. If your skin is dry and cracks, then apply moisturizer every day, but avoid putting lotion between the toes. Do not attempt to cut corns or calluses yourself, and do not use chemical agents or other irritants on your feet. If you notice anything of concern, you should see your podiatrist right away.

If you have diabetes, prevention and early detection of risk factors are the keys to happy, healthy feet! Talk to your podiatrist today to learn how they can help you and how you can help yourself. -
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