Hi, I’m Dr. Mitchell Wachtel and today we’re going to talk about diabetes and its effects on the foot and all the problems associated with it.
We see an incredible amount of foot problems that deal with diabetics. Diabetics for many years have been coming to my practice with typical problems like ulcers on the heel or forefoot. An ulcer is an opening in the skin. It’s typically due to pressure and the way we treat it is by routine evaluation. Sometimes we have to cut down the callus or palliatively debris the lesion with natural a scalpel to prevent them from becoming ulcerated. Many diabetics have circulatory problems. Over time fat can develop in the small arteries of the foot and the leg. Diabetics overall are just more prone to circulatory problems in the foot.
In our practice if we feel someone has a possible circulatory problem we can provide what we call a PAD test. This test is very important because what it does is that it tells us if someone has the ability to heal. If their circulation is very poor they could be at risk for heart attack or stroke. It’s a very simple vascular test that we do in the practice where we put blood pressures gauges near the knee, thigh, ankle, and even around the digits of the toes. Lastly, many of our patients that are diabetics don’t know proper care techniques of the feet so we go through a whole treatment protocol with them where we discuss their shoewear, if their hydrating their skin properly, if their creaming their skin properly, applying medicine to nails that may become fungal. Fungal toenails are a big problem in their practice where we find diabetics with thick fungal nails. When they get thick they can create an indentation in the skin and that can lead to an infection under the nail.
So these are all very important parts of evaluating diabetics. The main goal in our practice is to prevent ulcers, infections, proper skin exams, check the circulation and neurologic status. Some patients develop what we call neuropathy which is a burning sensation or a loss of sensation and that needs to be treated appropriately. If someone can’t feel where they’re going or walking they may develop a sore that wont heal. So in a nutshell the main problems with diabetics that we see in our practice are circulatory problems, skin problems, nail problems, and neurologic problems.