A Warning to All People With Diabetes

Everyone with diabetes should know that their feet are at risk. They also should realize that their risk increases exponentially as their blood sugar rises and their diabetes becomes uncontrolled. That being said, despite this knowledge, many people with diabetes do not take control of their disease like they should. I sometimes sound like a broken record when I speak to my diabetic patients about this, but I'm currently dealing with a situation that serves as a good reminder to me as to why I have to keep insisting that my patients remain vigilant against complications of diabetes.

It's a story of a very, very nice man who I saw first in my wound clinic. He had a seemingly minor ulcer beneath his left foot. We talked about the proper dressings, the need to keep the pressure off of the area, etc. Everything I would normally discuss in these circumstances. He did admit that his diabetes was not in great control, but he was working at it. In fact, a test later showed that his diabetes was not close to being in control!

A short time later I got a call at my office from his wife that she was concerned with the appearance of his foot. I had him come to my office immediately and found a rapidly deteriorating, infected foot. I admitted him to the hospital and operated on him to drain the infection, but it was not enough. A few days later I had to remove more tissue and amputate a toe. This all happenned in a short time frame of approximately 10 days.

Uncontrolled diabetes puts many of the body's systems at a deficiency. Of particular note is it's effect on the immune system, putting the diabetic's limb at a greater risk of infection and decreases the ability of the body to heal. For these reasons, I insist on the following routine to everyone with diabetes in my practice, from the "borderline" cases to those under poor control.

Along with diabetes often comes neuropathy, a decrease in sensation in the lower extremity which fails to alert the brain when a normally painful condition occurs. It is vital that people with diabetes inspect their feet daily. I suggest a 30-60 second inspection of the top and bottom of the feet, as well as between the toes. What you're looking for is any change from the day before. Any redness, cracking, bleeding, or pus is worthy of concern and a phone call to the podiatrist. If you cannot see the bottom of your foot, a spouse or child can help you. Otherwise, a mirror can be helpful. My patients are routinely told that I'd rather they call me and it be nothing than have them wait and postpone treating a problem.

For more information about diabetic foot care, visit www.tanglewoodfootspecialists.com
For more information about an easy to use illuminated mirror for foot inspections, click here
Dr. Andrew Schneider
Dr. Andrew Schneider is a podiatrist and foot surgeon at Tanglewood Foot Specialists in Houston, TX.
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