The Role of a Podiatrist on Your Diabetes Healthcare Team

When you have diabetes, a podiatrist is a key member of your healthcare team. Maintaining a relationship with a podiatrist for diabetic foot care can be critical in preventing serious health problems that could affect your mobility.  Comprehensive foot exams and treatments can avoid complications stemming from:

Neuropathy

Peripheral neuropathy indicates a problem within the peripheral nervous system. Symptoms include burning, numbness, shooting pain, tingling and muscle weakness or atrophy.  Peripheral neuropathy typically affects the feet and legs and sometimes affects the hands and arms. It’s caused by high blood glucose or blood sugar.

Peripheral neuropathy is common among diabetics. The National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) estimates about one-third to one-half of people with diabetes have the condition.

Since peripheral neuropathy can cause numbness, you might not feel a foot injury, cut or even a blister that could result in an ulcer. Foot ulcers are a considerable problem for people with diabetes, often leading to hospitalization.

Arthropathy

Having diabetes raises your risk of arthropathy, a term which refers to diseases and conditions of the joint, including arthritis. Charcot joint, also called neuropathic arthropathy, is a rare complication of diabetes neuropathy. Charcot foot can start out as a small injury or infection, which can go undetected because of nerve damage.

If Charcot foot is not treated early, it can make the joints collapse in the foot, permanently affecting mobility. It can also increase the chances that a foot infection will worsen and spread to other parts of the body. In severe cases, this can lead to needing your foot amputated or cause life-threatening complications.[1]

Poor circulation

Poor circulation is common among diabetics. High glucose levels over time can damage the lining of the small blood vessels, impeding circulation. Diabetes also increases the risk of peripheral arterial disease (PAD), which produces fatty deposits that narrow blood vessels, generally in legs and feet.  PAD reduces blood flow to the feet and can further delay healing of wounds as well as increase the risk of foot infection.

Warning signs it’s time for a podiatrist and diabetes care

The following symptoms should prompt a visit to a podiatrist or even your regular physician, says the CDC[2]

·         Tingling, burning, or pain in your feet.

·         A change in the color and temperature of your feet.

·         Dry, cracked skin on your feet.

·         Loss of feeling or ability to sense heat or cold.

·         Thick, yellow toenails.

·         Loss of hair on your toes, feet, and lower legs.

·         A fungus infection, such as athlete's foot, between your toes.

·         An ingrown toenail or a sore, such as a blister, ulcer, or infected corn

What to expect from a podiatrist and diabetes care

While you have a team of medical professionals to help you navigate your diabetes condition, the areas where a podiatrist can help you include:

Education

Your podiatrist can provide valuable information and advice in explaining how diabetes can and will affect your feet and lifestyle choices you can make to avoid foot problems and/or ensure they do not worsen. Your podiatrist can recommend what shoes to wear – they may even provide appropriate shoe fitting - to manage your diabetes and prevent foot sores; and how to recognize warning signs.

Your podiatrist also can advise how activities such as sports may affect your diabetes foot management. If you are suffering from diabetic foot symptoms, do the right exercises that will not increase the risk of injury. Feet-friendly exercises include walking, swimming and even bike riding nutrition advice. Nutrition is another area where your podiatrist can give advice. Smoking and drinking alcohol can make your diabetes worse.

In addition, diabetic foot care involves keeping your skin moisturized to keep it more flexible and less prone to cracks that can lead to infection. Your podiatrist can also advise on the right type of lotions to use to keep your feet. EASE-Z Diabetics’ Dry Skin Therapy Foot Cream is an over-the-counter offering that uniquely feature active Zinc Acetate to relieve and protect dry, cracked skin associated with diabetes. The product covers the skin with a thick protective layer that penetrates to provide real, long lasting-relief.  It is unscented and non-greasy for added comfort. Daily use gives superior recovery and continuous relief, assuring long-lasting comfort.

Management and prevention

Your podiatrist and diabetic care involve routine checkups and early detection of serious complications, as noted above. Your podiatrist can perform toenail care, since even a small cut can grow into a severe problem. This includes seeing your podiatrist for ingrown toenail problems.

People with diabetes often have trouble with corns and calluses, which can develop into complications.  Aggressive filing and rubbing can make these worse, and medicated pads, which are acids do not distinguish between dead and live skin. A healthy foot can handle damage to live skin, but a diabetic foot might not. Therefore, you will want to consult with your podiatrist about how to treat them properly. [3]

Treatment

You will want to see a podiatrist if you develop a foot ulcer. In that situation, your podiatrist and diabetic care involves treating the condition by “off-loading” which involves taking pressure off the area, removing dead skin (debridement) and applying medication or dressings to the ulcer. [4]

In case of developing Charcot disease, your podiatrist can help minimize foot pressure with a cast or suggest proper boots or even a wheelchair. Surgery might be necessary to mend the foot and ankle if the condition becomes more severe.

A podiatrist is your partner in diabetic foot care. Make sure to see them regularly and sooner if you notice a foot problem developing.