It is essential to thoroughly evaluate and periodically manage the diabetic patient. We know that diabetics can specifically have impaired circulation, reduced sensation, and a greater tendency to develop infections, ulcerations, and other skin problems. Early detection, periodic monitoring, and judicious care are essential in the prevention and management of diabetic complications. The lower legs and feet are primary locations for these problems to occur. Professional care and supervision can be highly effective in minimizing the complication tendencies of patients with diabetes.
Periodic care for these patients can range from a simple examination of one’s feet to more involved treatments of such problems as diabetic arthropathy (diabetic arthritis), peripheral neuropathy (loss of feeling), vascular complications, and ulcerations. The podiatrist will examine the feet to make sure that there is adequate blood supply and sensation (feeling) to the feet. A decrease or loss in one or both of the above can lead to infection and potentially more serious problems. In many cases, the podiatrist will involve by referral, other medical specialists to participate in the total team approach to managing the existing diabetic problems.
Many diabetics are seen by their foot specialists on a periodic basis for general foot care. It is important to keep the nails properly trimmed so that they do not become ingrown and cause infection. This is important, as many diabetics cannot fight infections as well as people without the disease. Also, the skin of diabetic patients is usually thinner and more susceptible to injury than that of non-diabetic persons. It is important to reduce the calluses to relieve pressure over the bony prominences of the feet. If there is too much callus build-up, the skin may break down and lead to an ulceration. An ulceration can become infected and possibly lead to more serious consequences requiring more involved care.