For years, we thought that ulcers simply raised your risk for amputation. (Which is a very big concern, don't get me wrong.) But now, a new study shows the problems could get so much worse.
Diabetic Ulcers Lead to Death
Recently, the American Diabetes Association shared some shocking news. A new study shows that diabetic patients with a history of ulcers have a higher risk of dying than of undergoing amputations. And those findings apply to patients with type 1 and type 2 diabetes.
Clearly, we need to do more to prevent ulcers. Or the country's diabetes epidemic will only get worse. So, with that in mind, here's how we prevent ulcers in my Houston podiatry practice.
First Line of Defense: Staying Healthy
Of course, controlling your diabetes is one of the best ways to prevent ulcers. You can do so by following a careful diabetic diet. And you should also stick to any prescribed medications, such as insulin. Quit smoking if you haven't already, and try to get to or stay at a healthy weight.
Together, these lifestyle measures can help prevent diabetic complications. But sometimes, they aren't enough. And that's why regularly seeing me in the office is important. Because I have many different ways to help keep ulcers from attacking your feet.
Next Level Care: Diabetic Shoes
Want to know one of the best tools I have to prevent foot ulcers? Well, you may be surprised. But it's actually diabetic shoes!
Here's the story. Therapeutic shoes can play a major role in preventing ulcers. Now, these aren't regular shoes you can buy just anywhere.
Rather, diabetic shoes have extra-depth. That way, they can accommodate any stuctural deformities in your foot. (Including bunions and hammertoe.) w Because of that, you can avoid putting extra pressure on those parts of your foot. And, since pressure can lead to ulcer formation, this is very important.
But that's not the only reason why these shoes are so effective. We also fit them to your feet in our office. During that process, one of our highly trained team members will insert a full-contact soft-molded insole to your new shoes. These will help manage pressure buildup under the foot. And, together, these features can stop diabetic foot ulcers before they form.
Once upon a time, these shoes were boxy, heavy and unattractive. But I get that patients want to protect their feet without sacrificing style.
For that reason, I've shopped high and low for the finest diabetic shoes available. And boy did I come through! Because now, I can offfer my diabetic patients high-quality brands such as Aetrex, Dr. Comfort, Orthofeet, and others. And, while they're no Manolos, these new diabetic options are as stylish as a therapeutic shoe gets.
More importantly? Medicare part B covers these shoes. (As do many private insurance carriers, for those who qualify.) And they go a long way towards preventing diabetic foot ulcers. But they can't do the work alone. Because we need some other at-home and in-office interventions.
Daily Foot Exams to Prevent Foot Ulcers
Then, that same sugar in your blood can damage your nerves. If that happens, you may develop peripheral neuropathy. (This means you lose sensation in your feet. And you may also experience burning or tingling pain.)
Do you see why that's a problem? When these two concerns combine, you might not notice a small cut. Then, because of blood flow problems, that cut could take weeks or months to heal. Eventually, infection can set in. And suddenly, you're facing a life-threatening ulcer.
Luckily, you can help me keep that ulcer from forming. And you can do so from the comfort of your own home! First, I need to keep your feet covered at all times when you're home. Going barefoot creates too many chances for you to get cut, banged or bruised.
Next, I need you to carefully examine your feet, every single day. I need you to look for cuts, bruises and blisters. But I also need you to look for signs of pressure on your feet. (Something as simple as sock-indents or red skin could spell trouble. Even a sore spot on your foot, without any visible marks, could be a problem.)
Then, if you notice any new changes, make an immediate appoinment in my office. There, I can offer you some other new weapons in the battle to prevent diabetic foot ulcers. And we'll know that we got to the problem within 24-hours of its formation.
Next Level Pressure and Heat Monitoring
I see all my diabetic patients several times a year for thorough foot exams. (Even when they don't have visible foot changes.) Recently, I've added new technology to these visits. It's purpose? To stop ulcers before they have the chance to develop.
I use one important system called Revealix to check for changes in your foot temperature. This new technology takes a thermal image of your feet, identifying warmer spots on your skin. Now, we know that your foot temperature rises before an ulcer forms. So we can consider higher heat an early warning sign. This information will help me relieve pressure from those trouble spots. Often, this will be enough to prevent an ulcer.
I also use special socks or insoles to help track my patient's feet, even when they're not in the office. (We call this remote patient monitoring.) These take-home devices also check your foot temperature. Then, if they notice a troubling change, they send me a message at the office. That way, I can get you in quickly. And hopefully keep an ulcer from developing.