Regular Foot Exams Can Help Diabetics Avoid Complications
If someone said that one specific action could reduce your chance of losing a limb by up to 85%, you’d likely listen and want more information – that’s a striking statistic.
“Diabetes can damage the nerves in your feet and legs. Neuropathy – which is numbness or tingling – can make people not feel the pain that comes with a wound or ulcer on the foot bottom,” said Brandon Tucker, DPM, podiatrist. “Sometimes they cannot see the issue, either.”
For people with diabetes, routine examinations of their feet can reduce the rates of amputation between 45-85%. Exams by foot-and-ankle specialists offer diabetics a complete evaluation – and can lead to preventive steps that will reduce the risk of ulcers as well as other serious outcomes.
“I’ve had an unfortunate number of diabetic patients who thought their feet were fine, mostly ignored them and then one day look down and see their feet are hot, red and swollen,” said Tucker. “By this time they already have a diabetic foot infection which puts them in a tough situation.”
Tucker shares these insights with any diabetic who is striving for their best health, especially in the extremities.
- Warning signs: People whose feet are too dry, too wet or who have bunions, hammer toes or poor circulation may face diabetic foot problems. “Even a few weeks can make a big difference and lead to ulceration, and in worst cases, amputation,” he said.
- Specialist exams: Podiatrists can work with diabetic patients to evaluate their feet and ankles on a wide range of aspects, including vascular, musculoskeletal, neurological and dermatological levels. “Many diabetics have microvascular conditions that can make wounds on their feet difficult because nutrients cannot get to the wound to help them heal. That can lead to infections,” said Tucker.
- Levels of severity, frequency of exams: Patients with diabetes are classified on a risk scale from 0 to 3, and those with numbness (neuropathy) would be considered level 1. “Patients with neuropathy should have their feet checked every six months, and those who have that numbness along with a foot deformity such as bunions should go every three to six months,” Tucker said. “Patients who are classified as level 3 risk have neuropathy as well as a history of ulceration or amputation – they should have exams every one to three months.” He added that each patient with diabetes is unique; initial exams usually take about 30 minutes and follow-ups are shorter.
- Treatment and coverage: Most insurance plans cover preventive exams and diabetes care. Since foot wounds are slow to heal, treatment can vary, but prevention is key. “We can prescribe insoles and take steps to prevent the development of an ulcer, which is the best outcome,” he said. “If an ulcer has developed, treatment can last weeks, and in some cases, many months. Our overarching goal is to get the diabetes under control, and while we do that, we address the wound.”
- Education can stop infection: Knowledge of warning signs and appointment frequency is a great tool toward stopping infection issues with the feet of diabetic patients. When an infection goes untreated, it can lead to hospital admissions and IV antibiotic treatment. “We can treat some infections with antibiotics taken at home, but others may require IV antibiotics,” he said. “Recognizing the reality of the problem and doing everything possible – including routine exams – is the best strategy. Untreated, some wounds can lead to necrotizing bacteria that spread to the point that a below-the-knee amputation is needed.”
Talk to your primary care provider, your diabetes educator or a podiatrist to avoid complications of diabetes.