Diabetic Foot

Dr. Magdalena Blasko has the knowledge and experience treating patients with diabetic foot issues for nearly two decades and wants to help you as well. If you're ready to receive the level of care you deserve, call us at (415) 353-5715 or book online to the right. If not, read on to see how we can help! Hope to see you soon!

Diabetic foot is a condition in which the poor circulation (peripheral artery disease) in the lower extremities is coupled with a loss of sensation (diabetic neuropathy) and muscle atrophy. This pairing is especially dangerous because the loss of sensation in one’s feet acts like a disabled warning signal when it comes to being alerted to underlying issues. Our highly trained health professionals at Magdalena Blasko, DPM, Inc. can deal with prevention, diagnosis and management of all your diabetic foot related problems.

What is Diabetic foot?

Diabetic foot is a long term complication of diabetes mellitus (the diabetes everyone is familiar with, affecting blood sugar levels). It is a pathology that results from a lack of blood supply to the affected area. Sensory neuropathy (damage of nerves) occurs due to uncontrolled blood sugar levels in a diabetic patient, with the nerve endings essentially “frying” with the constant wide swings in blood sugar.

What are the symptoms of diabetic foot?

  • Loss of sensation.

  • Numbness or tingling.

  • Blisters and other wounds – usually painless.

  • Skin discoloration.

  • Temperature changes.

  • Painful tingling – sometimes with increased sensation.

  • Heaviness in the legs due muscle weakness.

  • Balance problems.

  • Some complications of diabetic foot include nonhealing ulcers, infections and abscesses, gangrene (tissue death) with bone infection and foot deformity. Charcot’s foot is a late complication when the shape of the foot changes by collapsing at the arch.

How can diabetic foot cause pain?

  • Diabetic neuropathy is nerve damage that can give rise to painful tingling in one’s feet, sometimes unbearable. This usually occurs during the initial stages of nerve damage.

  • Peripheral arterial disease is a complication of diabetes where the circulation is affected. Lack of blood supply to one’s feet leads to painful tissue ischemia (inadequate blood flow).

  • Gangrene (tissue death) causes severe pain in the affected area.

  • Infection in one’s feet will almost certainly cause pain.

  • Although most diabetic foot ulcers are painless, they become painful when infected.

  • Muscle weakness leads to arthritic changes which can become debilitating.

Proper diabetes management and regular foot care will help prevent complications in the foot and delay or even avoid the need for a wheelchair. The most frequent and unfortunate story is that it begins with a foot or leg wound. The diabetic patient also suffers from a loss of sensation in the injured area which causes them to realize there is an issue later than they would have. The patient then seeks medical help too late, leading to long-term wound care, possible hospitalization or even amputation.

When should you see a Podiatrist?

Your podiatrist can inspect your feet for early signs of nerve damage, poor circulation and other problems related to your feet. Schedule foot exams regularly at least once a year or more often if recommended by your doctor.

However, if you notice the following changes, you should seek immediate medical attention:

  • Changes in skin color of your feet such as redness or blackening.

  • Swelling of your feet.

  • Persistent sores/ ulcers or signs of infection.

  • Ingrowing toe nails.

  • Temperature changes in your feet.

  • Constant pain or tingling in your feet.

  • Fungal infections or athlete’s foot.

  • Dry, cracked skin on your heels.

  • Itching.

  • Leaking of fluid from tiny pinpoint wounds.

Discuss any foot pain or discomfort with your podiatrist to ensure it is not a serious problem, as most of the time neglected feet can lead to severe consequences.

How will your podiatrist manage diabetic foot?

First, we will identify the reasons why you get pain by carefully examining your feet. Treatment will be aimed to eliminate the cause of your pain as well as symptomatic pain management.

  • If your pain is due to infection, a course of antibiotics will be prescribed. A swab culture, blood culture and ABST (antibiotic sensitivity testing) will help to identify the causative organism.

  • If your pain is suspected to be due to peripheral artery disease, we will order doppler studies to assess blood circulation in your feet. Antiplatelets and anti-clotting medications will be prescribed if necessary, to reduce tissue ischemia.

  • If there are ulcers, proper ulcer management will be done with wound debridement, dressing and off-weighting.

  • Sometimes surgical procedures are recommended. Pressure around the ulcers can be alleviated by shaving down the bone to  reduce weight-bearing pressure. Removal of bony deformities like bunions or hammertoes may be helpful to prevent ulcer formation. If the pain is a result of gangrene with bone infection, amputation is inevitable to save the rest of the limb from further death.

  • Prescription of pain relievers is dependent on the patient’s situation – like Tylenol, NSAIDS or nerve specific drugs like Lyrica or Neurontin.

Topicals, like creams and gels, will also help to reduce the pain felt in your feet. Lidocaine or capsaicin are available over the counter, but the best course of action is to follow the doctor’s recommendation.

A podiatrist can fit you with shoe inserts (orthotics) to support your feet if you have diabetic nerve pain. If pain or weakness of muscles are so severe that it is too difficult to walk, orthopedic shoes or  a foot brace might help.

The best way you can prevent diabetes related foot complications is by managing your diabetes well, seeing as fluctuating high blood sugar levels are the reason for nerve damage. This nerve damage then influences the circulation, the muscle tonus and strength and the quality of the skin. Our specialized team can advise you on how to keep your blood sugar levels controlled, by adhering to a balanced diet plan and regular exercise as well as taking the medications and insulin as prescribed. If you bring your blood sugar into a healthy range, you can reduce the risk of further nerve damage.

If you smoke, quitting it will be beneficial to reduce effects of peripheral arterial disease and therefore pain. If you are having trouble quitting, we can recommend treatment and support groups that are suitable for you. Maintain a healthy weight to help control sugar levels better. This will reduce the pressure on your feet, reducing joint and muscle pain.

A podiatrist plays an important role in diabetic foot care as we provide vital advice and care that will help manage your conditio. We offer a comprehensive fall risk assessment and prevention program that helps us identify all the underlying conditions which may be lying in wait and craft a strategy to fight back. We have found that this allows our patients to stay on their feet longer by fostering independent living throughout their golden years. If your independence is important to you, stop in and let us help you to keep it for years to come.

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