Diabetic Foot Care

May 8, 2010

According to the American Diabetes Association, about 15.7 million people (5.9 percent of the United States population) have diabetes. Nervous system damage (also called neuropathy) affects about 60 to 70 percent of people with diabetes and is a major complication that may cause diabetics to lose feeling in their feet or hands.

Foot problems are a big risk in diabetics. Diabetics must constantly monitor their feet or face severe consequences, including amputation. With a diabetic foot, a wound as small as a blister from wearing a shoe that’s too tight can lead to a lot of damage. Diabetes decreases blood flow, so injuries are slow to heal. When a wound is not healing, is at risk for infection and infections spread quickly in diabetics.

When a diabetic foot becomes numb, it may be at risk for deformity. One way this happens is through ulcers. Small, unattended cuts become open sores, which may then become infected. Another way is the bone condition CharcotFoot. This is one of the most serious foot problems diabetics face. It warps the shape of the foot when bones fracture and disintegrate, and yet, because of numbness there is no pain, and the individual continues to walk on the foot. Our practice can treat diabetic foot ulcers and early phases of Charcot (pronounced “sharko”) fractures using a total contact cast and prevent more serious damage or deformity. This treatment allows the ulcer to heal by distributing weight and relieving pressure. For Charcot Foot, the cast controls foot movement and supports its contours

If you have diabetes, you should inspect your feet every day. Look for puncture wounds, bruises, pressure areas, redness, warmth, blisters, ulcers, scratches, cuts, and nail discoloration. Get someone to help you, or use a mirror.

Here’s some basic advice for taking care of diabetic feet:

  • Always keep your feet warm.
  • Don’t get your feet wet in snow or rain.
  • Keep feet away from heat (heating pads, hot water pads, electric blankets, radiators, fireplaces). You can burn your feet without knowing it. Water temperature should be less than 92 degrees. Estimate with your elbow or bath thermometer (you can get one in any store that sells infant products).
  • Don’t smoke or sit cross-legged. Both decrease blood supply to your feet.
  • Don’t soak your feet.
  • Don’t use antiseptic solutions (such as iodine or salicylic acid) or over-the-counter treatments for corns or calluses.
  • Don’t use any tape or sticky products, such as corn plasters, on your feet. They can rip your skin.
  • Trim your toenails straight across. Avoid cutting the corners. Use a nail file or emery board. If you find an ingrown toenail, contact our office for treatment.
  • Use quality lotion to keep the skin of your feet soft and moist, but don’t put any lotion between your toes.
  • Wash your feet every day with mild soap and warm water.
  • Wear loose socks to bed.
  • Wear warm socks and shoes in winter.
  • When drying your feet, pat each foot with a towel and be careful between your toes.
  • Buy shoes that are comfortable without a “breaking-in” period. Check how your shoe fits in width, length, back, bottom of heel, and sole. Avoid pointed-toe styles and high heels. Try to get shoes made with leather upper material and deep toe boxes. Wear new shoes for only two hours or less at a time.
  • Don’t wear the same pair of shoes everyday. Inspect the inside of each shoe looking for foreign objects, protruding nails, or any rough spots inside before putting them on. Don’t lace your shoes too tightly or loosely.
  • Choose socks and stockings carefully. Wear clean, dry socks every day and always wear socks with shoes. Avoid socks with holes or wrinkles. Thin cotton socks are more absorbent for summer wear. Square-toes socks will not squeeze your toes. Avoid stockings with elastic tops or garters.
  • Never wear sandals or thongs (flip-flops) and never go barefoot, indoors or out.
  • In the winter, wear warm socks and protective outer footwear. Avoid getting your feet wet in the snow and rain and avoid letting your toes get cold.
  • Don’t file down, remove, or shave off corns or calluses yourself.

Contact our office immediately if you experience any injury to your foot. Even a minor injury is an emergency for a patient with diabetes.

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According to the American Diabetes Association, about 15.7 million people (5.9 percent of the United States population) have diabetes. Nervous system damage (also called neuropathy) affects about 60 to 70 percent of people with diabetes and is a major complication that may cause diabetics to lose feeling in their feet or hands.

Foot problems are a big risk in diabetics. Diabetics must constantly monitor their feet or face severe consequences, including amputation.

With a diabetic foot, a wound as small as a blister from wearing a shoe that’s too tight can cause a lot of damage. Diabetes decreases blood flow, so injuries are slow to heal. When your wound is not healing, it’s at risk for infection. As a diabetic, your infections spread quickly. If you have diabetes, you should inspect your feet every day. Look for puncture wounds, bruises, pressure areas, redness, warmth, blisters, ulcers, scratches, cuts and nail problems. Get someone to help you, or use a mirror.

Here’s some basic advice for taking care of your feet:

  • Always keep your feet warm.
  • Don’t get your feet wet in snow or rain.
  • Don’t put your feet on radiators or in front of the fireplace.
  • Don’t smoke or sit cross-legged. Both decrease blood supply to your feet.
  • Don’t soak your feet.
  • Don’t use antiseptic solutions, drugstore medications, heating pads or sharp instruments on your feet.
  • Trim your toenails straight across. Avoid cutting the corners. Use a nail file or emery board. If you find an ingrown toenail, contact our office.
  • Use quality lotion to keep the skin of your feet soft and moist, but don’t put any lotion between your toes.
  • Wash your feet every day with mild soap and warm water.
  • Wear loose socks to bed.
  • Wear warm socks and shoes in winter.
  • When drying your feet, pat each foot with a towel and be careful between your toes.
  • Buy shoes that are comfortable without a “breaking in” period. Check how your shoe fits in width, length, back, bottom of heel, and sole. Avoid pointed-toe styles and high heels. Try to get shoes made with leather upper material and deep toe boxes. Wear new shoes for only two hours or less at a time. Don’t wear the same pair everyday. Inspect the inside of each shoe before putting it on. Don’t lace your shoes too tightly or loosely.
  • Choose socks and stockings carefully. Wear clean, dry socks every day. Avoid socks with holes or wrinkles. Thin cotton socks are more absorbent for summer wear. Square-toes socks will not squeeze your toes. Avoid stockings with elastic tops.

When your feet become numb, they are at risk for becoming deformed. One way this happens is through ulcers. Open sores may become infected. Another way is the bone condition Charcot (pronounced “sharko”) foot. This is one of the most serious foot problems you can face. It warps the shape of your foot when your bones fracture and disintegrate, and yet you continue to walk on it because it doesn’t hurt. Diabetic foot ulcers and early phases of Charcot fractures can be treated with a total contact cast.

The shape of your foot molds the cast. It lets your ulcer heal by distributing weight and relieving pressure. If you have Charcot foot, the cast controls your foot’s movement and supports its contours if you don’t put any weight on it. To use a total contact cast, you need good blood flow in your foot. The cast is changed every week or two until your foot heals. A custom-walking boot is another way to treat your Charcot foot. It supports the foot until all the swelling goes down, which can take as long as a year. You should keep from putting your weight on the Charcot foot. Surgery is considered if your deformity is too severe for a brace or shoe.

Plantar fasciitis is the term commonly used to refer to heel and arch pain traced to an inflammation on the bottom of the foot. More specifically, plantar fasciitis is an inflammation of the connective tissue, called plantar fascia, that stretches from the base of the toes, across the arch of the foot, to the point at which it inserts into the heel bone. Overpronation is the most common cause of plantar fasciitis. As the foot rolls inward excessively when walking, it flattens the foot, lengthens the arch, and puts added tension on the plantar fascia. Over time, this causes inflammation.

Also known as heel spur syndrome, the condition is often successfully treated with conservative measures, such as the use of anti-inflammatory medications, ice packs, stretching exercises, orthotic devices, and physical therapy. Note: Please consult your physician before taking any medications. In persistent cases, Extracorporeal Shock Wave Treatment (ESWT) may be used to treat the heel pain.

Our Staff

May 1, 2010

All our professionals maintain the highest levels of accreditation and pursue ongoing education to stay abreast of the latest trends in podiatry.

Stephen T. Frascone, DPM

Dr. Stephen Frascone earned his Bachelor of Science degree from St. John’s University in his home state of Minnesota, and completed his postgraduate medical training at the Iowa College of Podiatric Medicine and Surgery in 1993. He then completed a three year surgical residency at St. John Hospital – North Shores in Harrison Twp. He also completed a fellowship in traumatology and reconstructive foot and ankle surgery at The University Clinic for Traumatology in Vienna, Austria. Dr. Frascone is Board Certified, a Diplomate of the American Board of Podiatric Surgery, a Fellow of the American College of Foot and Ankle Surgery, and is certified as a wound care specialist by the American Academy of Wound Management. His specialty interests include endoscopic and arthroscopic procedures, elective reconstructive foot and ankle surgery, diabetic preventative care and chronic wound management.

 

Matthew Hansen, DPM

Dr. Hansen earned his Bachelor of Science degree in chemistry from Madonna University in Livonia, Michigan. His post graduate medical training was completed at the Ohio College of Podiatric Medicine in Cleveland, Ohio. He then completed a three year podiatric surgical residency at St. John North Shores Hospital in Harrison Township, Michigan. Dr. Hansen is Board Certified by the American Board of Podiatric Surgery. He is a member of the American College of Foot and Ankle Surgeons.His extensive surgical training involves reconstructive foot and ankle surgery, flatfoot procedures, arthroscopic and endoscopic techniques, diabetic limb salvage, and wound care management. Dr. Hansen’s hobbies include playing softball, snowmobiling, mountain biking, and time spent with his family.

 

Laura LaMar, DPM

Dr. Laura LaMar earned her Bachelor of Science degree from Michigan State University, and completed her postgraduate medical training from the Temple University School of Podiatric Medicine in Philadelphia Pennsylvania in 2000. She then went on to complete a three year podiatric surgery residency at St. John North Shore Hospital in Harrison Township, Michigan. She is board qualified in foot surgery, as well as reconstructive foot and ankle surgery by the American Board of Podiatric Surgery. She is a member of both the American Podiatric Medical Association, as well as the American College of Foot and Ankle Surgeons. Her specialty interests include reconstructive foot and ankle surgery including diabetic limb salvage as well as trauma, surgery, arthroscopic procedures, pediatric procedures, sport related injuries, wound care as well as forefoot surgery.

 

Jonathan King, DPM

Dr. Jonathan M. King was raised in Rigby, Idaho and completed his undergraduate degree work at Idaho State University. He later received his Doctorate of Podiatric Medicine degree from Des Moines University in Iowa. He went on to complete a three year podiatric surgical residency at Henry Ford Macomb Hospital in Clinton Township, Michigan. In addition to his extensive training in the medical and surgical management of the foot and ankle, he also received specialized training in arthroscopic, traumatology and reconstructive forefoot and rear foot surgery. He practiced in the Phoenix, AZ Metro area previously before joining Great Lakes Foot and Ankle. He and his wife and three boys are glad to be back in Michigan.