Diabetic foot care shouldn't be overlooked

Foot health may not be forefront on the minds of all diabetics, but podiatrists say its importance should not be underestimated.

"It's interesting because diabetes affects so many different systems: the eyes, kidneys, heart, feet," said Dr. Aaron Solomon, podiatrist at Advanced Foot Care Centers. "There is definitely a multi-specialist approach that needs to be taken, and I think the foot doctor is equally as important as the other doctors. One thing I tell patients is, if we're seeing sores with this, imagine what's happening to your eyes and heart and kidneys.

"Feet can be a barometer."

A lot of the problems podiatrists see in diabetic patients stem from neuropathy - nerve damage that can result from diabetes, causing numbness, tingling, pain and/or weakness in the feet. Patients with neuropathy may be walking around on injured feet without realizing it because they can't feel it, and the untreated wounds can develop into serious health problems.

"We see dry skin, cracks, fissures, nerve pain; symptoms as severe as wounds," said Solomon, who has practiced podiatry at Advanced Foot Care for nearly 12 years. "Sometimes patients will come in with severe pain or a sore that won't heal, and they won't know that their blood sugar is elevated."

With diabetes, prevention and treatment go hand in hand, he said. Reversing effects of the disease isn't always possible, but many of the variables depend on the patient's control of his or her blood sugar."A lot of the time, what we're trying to do as podiatrists is see what we can do to prevent the sores and the pain associated with neuropathy," he said. "Obviously, the most important treatment is controlling the blood sugar, but beyond that, we can fit patients with diabetic shoes to cradle and support the feet. There are some medications that can, in some cases, help with the nerve damage, but not necessarily reverse it. They help with the blood supply to the nerves - we're trying to prevent further damage."

Solomon said there are several things patients with diabetes can do to stay on top of any foot issues.

"Just making sure they're checking their feet on a regular basis is the most important thing," he said. "Looking for scratches and sores all over the feet and between the toes; making sure their shoes aren't too tight or too loose, because either one of those can rub and cause blisters. Even if they think it's something trivial, they can pick up the phone and call us and we can take a look at it so that it doesn't become a serious issue."

Solomon said the doctors and staff at Advanced Foot Care have many resources available for diabetic patients, from performing comprehensive diabetic foot examinations to fitting patients for diabetic shoes.

"We can even make custom-molded inserts for a patient's foot if there is a deformity," he said. "If they have neuropathy and a deformity, it can become a pressure area that can turn into a sore really easily. Depth shoes, or diabetic shoes, have rigid outer soles but make room on he inside to accommodate the inserts."

Advanced Foot Care can also perform wound care and surgery if needed."Our goal as surgical podiatrists is limb-salvage: to address serious issues and yet save the foot and let the patient have a good-quality life," said Solomon.

Diabetic patients should visit their podiatrist on a regular basis, depending on the severity of their health problems, he said.

"Any patient with a history of wounds or amputation should have checkups about a month apart, while those with severe neuropathy should usually come in quarterly," said Solomon. "Those with diabetes but no serious problems can probably be seen biannually or annually. I see many patients with diabetes who don't have foot problems. It's all about controlling their diabetes."