By Dr. Richard Berkun
For diabetic patients, a minor foot irritation or injury can lead to major surgery if proper care isn’t given.
This is true for John Okal, a New York native who was diagnosed as diabetic approximately 20 years ago. In 2000, when John moved south to sunny Florida one of the first things on his “to do” list was to find a reliable podiatrist. Luckily for John, a neighbor recommended Cortez Foot and Ankle Specialists. John recalls that after learning Dr. Berkun was a fellow New Yorker, they became fast friends and he hasn’t sought treatment elsewhere since his first visit in late 2000. John values the relationship he has with Dr. Berkun and the others in the office at Cortez Foot and Ankle Specialists. He knows how important it is for everyone, especially those with diabetes, to take proper care of their feet.
Elevated blood sugar often leads to poor circulation. If an ulcer appears, without proper blood supply to the feet, it is difficult to heal. The risk of infection also increases as a result of the bacteria caused by the excess sugars in the blood. Many diabetic patients lose sensation to their feet as a result of neuropathy, or nerve damage, caused by the disease. This lack of feeling is dangerous. If an injury does occur, but it goes undetected for some time, it could result in irreversible damage. It is estimated that without proper blood sugar control, 70-80 percent of diabetics develop neuropathy after 15 years – and after 20 years the number jumps to 100 percent!
Podiatrists have an extremely important role to play in the prevention and management of complications of the foot in those with diabetes. Diabetics who are at risk for a problem should have that risk status assessed every nine weeks (more if risk is greater). When something does go wrong, see a podiatrist immediately. Waiting “a few days to see what happens” before seeing someone may mean the difference between a good and poor outcome. The sooner treatment is started the better.
John agrees with the experts, prevention is the best way to protect diabetic feet. “I was fortunate enough to learn early in my diagnosis how to manage my blood sugar level and keep diabetes under control, minimizing the effects it has on my overall health. A vital part of my routine care is proper foot care maintenance.” Like many diabetic patients, John wears orthotics and shoes designed specifically for diabetes patients that he gets from Cortez Foot and Ankle Specialists.
The foot is especially affected by diabetes because it damages the nerves, which is called peripheral neuropathy. Diabetes also affects the circulation. Poor circulation can affect the ability of the body to heal when damage occurs. Those with diabetes are more prone to infection. The body responds slowly to infection and often has trouble resolving infections due to poor circulation. Other complications that can also affect the foot include kidney disease, which affects proteins needed in healing. Then, eye disease or retinopathy may prevent you from seeing your foot clearly. The foot is at risk for injury and you would not be even be aware if had happened. For example, if your shoe rubs a sore on a toe and it gets infected, you may not feel it because of neuropathy. You cannot heal well due to infection and poor circulation. A foot ulcer occurs. Infection spreads and sometimes the final result of this process is an amputation.
Dr. Berkun recommends that those with diabetes see a podiatrist at least two to four times per year, depending on their foot health. “Patients should clean and inspect their feet daily checking for any issues. Dried, cracked feet can be a breeding ground for bacteria. If anything is found during these daily checks an appointment with a podiatrist should be made as soon as possible. Even the smallest of cuts or a blister can lead to major problems for a diabetic if not cared for properly.”
John currently visits Dr. Berkun every few months for routine foot care maintenance. He recalls that he used to have more calluses and would have to make an office visit more frequently, but since using the orthotics and shoes that Dr. Berkun recommended he is able to keep his feet in better health. “Dr. Berkun is a great podiatrist. If I ever have any issues with my feet, I trust that he will be able to properly diagnose and treat them. I always follow the protocols he recommends. Now, I can’t always say that about all my others doctors, but I can with certainty when it comes to Dr. Berkun and his staff.”
Dr. Berkun and the team of podiatrists at Cortez Foot and Ankle Specialists treat diabetic feet and their complications every day. Such things as regular diabetic foot exams, diabetic shoes, orthotics, wound care and surgery are a few of the many treatments available. If you have any questions about how to properly care for diabetic feet, please call the office nearest you: Bradenton 941-758-8818, Parish 941-776-5199, Sarasota 941-360-9300.
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