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Diabetic Foot Exams

People with diabetes may become prone to many foot problems. When you have diabetes, you need to be aware of how foot problems can arise from disturbances in the skin, nails, nerves, bones, muscles, and blood vessels.  Furthermore, in diabetes, small foot problems can turn into serious complications.

A major goal of the foot and ankle surgeon is to prevent amputations of the foot in diabetic patients.  There are many new surgical techniques available to save feet and legs including joint reconstruction and new topical wound healing technologies.  Getting regular foot checkups and seeking immediate help when you notice something out of the ordinary regarding your feet can keep small problems from getting out of hand.  Your foot and ankle surgeon works together with other health care professionals to prevent and treat diabetic complications.

Inspect your feet daily.  Evaluate your skin and toenail daily.  Look for cuts, scrapes, redness, drainage, swelling, bad odor, rash, discoloration, loss of hair on toes, injuries, or nail changes (deformed, striped, yellowed or discolored, thickened, or not growing).  Also look for signs of fracture.  If your foot is swollen, red, hot, or has changed in size, shape, or direction,  please see your foot and ankle surgeon immediately. (If your eyesight is poor, have someone else do it for you.)

Observe for changes in circulation.  Pay attention to the color of your toes.  If they turn red, pink, or purplish when your legs hang down while sitting, poor circulation may be a problem.

Don't ignore leg pain.  Pain in the leg that occurs at night or with a little activity could mean you have a blocked artery. Seek care immediately.

Nail cutting.  If you have any nail problems, such as hard and/or thick toenails or reduced feeling in your feet, your toenails should be trimmed professionally.

No bathroom surgery.  Never trim calluses or corns yourself, and don't use over-the-counter medicated pads.   These often irritate the surrounding skin and make a bad situation worse.

Keep floors free of sharp objects.  Make sure there are no needles, insulin syringes, or other sharp objects on the floor.

Don't go barefoot.  Wear slipper indoors.  Wear shoes, sandals or boots outdoors. 

Diabetes-Related Foot and Leg Problems: Having diabetes puts you at increased risk for developing a wide range of foot problems, however with proper control of your blood glucose you do not have to become a victim of your disease. 

Infections and ulcers (sores) that don't heal: Because of poor circulation in the feet, cuts or blisters can easily turn into ulcers that become infected and won't heal.  An ulcer is a sore in the skin that may extend all the way down to bone.  Ulcers are a common and potentially serious complication of diabetes that may lead to a loss of your toe, foot, leg, or life.  

Corns and calluses: When neuropathy is present, you can't tell if your shoes are causing pressure resulting in corns or calluses.  Corns and calluses must be properly treated or they can develop into ulcerations.

Dry, cracked skin: Poor circulation can make your skin dry.  This may seem harmless, but dry skin can result in cracks that may become infected and lead to additional problems.

Nail disorders: Ingrown toenails (which curve into the skin on the sides of the nail) and fungal infections can go unnoticed because of loss of feeling.  If they're not professionally treated, they can lead to infection of both skin and bone.

Hammertoes and bunions: Motor neuropathy (nerve damage affecting muscles) can cause muscle weakness and loss of muscle tone in the feet, resulting in hammertoes and bunions.  If left untreated, these deformities may lead ulcerations.

Brittle bones: Neuropathy and circulation changes may lead to brittle bones (osteoporosis).  This makes you susceptible to breaking a bone, even without a major blow or injury occurring.

Charcot foot: This is a complex foot deformity resulting in multiple broken bones and mass soft tissue destruction resulting from diabetic neuropathy.  Because of the neuropathy, the pain of the fractures goes unnoticed and the patient continues to walk on the broken bones, making matters worse.  This disabling complication is so severe that reconstructive surgery or even amputation may become necessary.

Blocked artery in the calf: In diabetes, the blood vessels below the knee often become narrowed and the flow of blood restricted.  A severely blocked artery is a serious condition that may require intervention from a vascular surgeon.  If vascular surgery fails or the wound does not heal, amputation may become necessary.

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