“Hi, I’m Dr. Mitchell Wachtel and today we’re going to talk about diabetes and the importance of routine palliative foot care. A multitude of problems can occur in diabetics. Simple things that we recommend, especially if you’re a diabetic, are routine evaluations by a podiatrist. Typically we recommend that you be seen once every three months for an exam. Typically the things we’ll do while you’re in the office are check for circulation problems, neurologic problems, and/or biomechanical problems of the feet and the way you walk. Sometimes we’ll also do what we call a gait exam as well to see if you’re walking on the outside of your foot or on the inside of your foot and also determine if you have some sort of arch or ankle problem. The reason it’s very important to do this is to decrease any kind of problems, such as infections, from occurring.
Routinely in the office we provide foot care for patients who are diabetic. The problems can be something like a fungal nail. Fungal nails can be a discoloration of the nail. We have a wonderful array of topical treatments that can effectively kill the fungus in the nail. Sometimes we’ll have to apply topical medications along with oral medications and we can diagnose the actual fungus by sending the nail for biopsy. The other problems are the calluses that we’ve discussed before. Calluses are a hardening or thickening of tissue. Typically what we call a corn is a lesion on the top of the toe. It typically occurs from a boney prominence that’s rubbing up against the top of a shoe. A callus is typically a lesion that occurs on the bottom of the foot and is caused from a bearing of weight area and a boney prominence. We need to typically, palliatively shave down the lesion so it doesn’t become problematic later on. The other treatments for a callus are making a certain type of a shoe with a certain type of an insert, we call that an orthotic. That will decrease pressure at the area and effectively help in getting rid of the lesion.
Sometimes if all conservative treatments fail for these lesions we may have to provide a minor surgical procedure to prevent the callus from becoming infected.
We have a wonderful treatment regimen at our office with a multitude of different creams for dry skin. Dry skin can cause fissures or cuts in the actual skin that can become infections later on. You can see them sometimes become white cracks that open up and becomes very hard for the skin to properly heal and close up the crack(s). So moisturization of the actual foot is extremely important for diabetics. We try to prevent any kind of openings or sores that can occur from even a crack or callus.”