November was National Diabetes Month in the United States. Since we get lots of questions from diabetics I thought this would be a good time to review some basic information about the subject of diabetes and your feet.

Every year patients with diabetes should get a foot examination to avoid the dire consequences of diabetes. Amputation of toes, feet, or legs are sometimes the tragic result of poor circulation or foot ulcers (open sores) that could have been treated, easily, with early diagnosis. Each year, more that 67,000 lower limbs are amputated due to the complications from diabetes. Approximately five to fifteen percent of all people with diabetes will undergo that type of amputation in their life time. Seventy to eighty percent of those amputations are the result of chronic foot ulcers.

Diabetes is a systemic disease affecting many different parts of the body. Ideal management of this disease requires a team of medical specialists; the podiatric physician is an integral member of the team. The keys to preventing diabetes-related amputation are regular foot screenings and patient education/involvement. The patient should know to watch for certain warning signs of poor circulation: changes in skin color, open foot sores, foot sores slow in healing, elevation in skin temperature, foot or ankle swelling, leg pain, ingrown or fungal toe nails, bleeding corn or callus and/or dry cracked skin at heels. With any of these signs a diabetic should see their podiatric physician for treatment.

Lowering the risk of amputation for patients with diabetes involves what I like to call TLC. Patient education and active care are weapons in healthful diabetes management to avoid complications. The following are some necessary steps to avoid lower limb complications:

1. Wash your feet at least once daily with mild soap and warm water. Dry them well and inspect for sores and cuts.(If you are unable to see the foot use a hand held mirror or get some help).

2. Cut toe nails straight across do not dig in corners(If unable to reach or see the foot allow your podiatrist to trim your nails).

3. Stop smoking and limit the use of alcohol.

4. Exercise daily, this improves your circulation. Consult your doctor for a program of exercise.

5. Be properly measured and fitted each time you buy a new pair of shoes. Alternate shoes daily.

6. Wear thick, soft socks to avoid rubbing and irritation.

7. See a doctor of podiatric medicine, regularly especially to treat corns, calluses, warts and to have foot ulcers treated safely. Diabetic foot problems can be prevented with regular care and patient involvement. So get your annual foot checkup, examine those feet/shoes and be active for your diabetic foot health.

Dr. Ravick is past president of the DC Podiatric Medical Association, a spokesperson for the American Podiatric Medical Association, in private practice at Capital Podiatry Associates since 1980 and often quoted in national and local media.

Founded in 1912, the American Podiatric Medical Association is the nation’s leading professional society for foot and ankle specialists, with membership of over 10,000 doctors of podiatric medicine. For more information on athletic footwear you can visit the APMA website or call 1-800-FOOTCARE to request a free brochure.