Diabetic Foot & Ankle Disorders
What is Diabetes?
Diabetes mellitus - often called "sugar disease" - is a serious disorder that can lead to blindness, amputation, kidney failure, stroke and heart attacks. Marked by the inability to manufacture or properly use insulin, diabetes impairs your body's ability to convert sugar, starches and other food into energy. The long-term effect is damage to the eyes, heart, kidneys, feet, nerves and blood vessels.
Your Doctor of Podiatric Medicine & You
As a foot and ankle specialist, the doctor of podiatric medicine (DPM) plays an integral role in the medical care of people with diabetes. In fact, DPM's have documented success in the prevention of amputations. The key is to see a podiatric physician for a foot check-up at least annually and preferably more often. According to most studies, fifteen percent of all people with diabetes will develop open wounds on their feet at some point during their lifetimes. Of these ulcerations, twenty percent will result in amputation. And more than fifty percent of those who undergo an amputation of one limb will also lose the other within three to five years.
Diabetic Foot Problems: General Considerations
Foot problems are a leading cause of hospitalization for the sixteen million persons in the United States who have diabetes (almost half of whom are unaware of their condition--according to the American Diabetes Association). It is estimated that 15% of all diabetics will develop a serious foot condition or ulcer at some time in their lives. Of these ulcerations, 20% will result in amputation. And more than 50% of those who undergo an amputation of one limb will also lose the other limb within three to five years.
As a foot and ankle specialist, the doctor of podiatric medicine (DPM) plays an integral role in the medical care of people with diabetes. In fact, DPM's have documented success in the prevention of amputations. The key is to see a podiatric physician for a foot check-up at least annually and, preferably, more often. See your podiatrist if you suspect any problem with the foot whatsoever. Prevention is the best treatment.
Common problems include infection, ulceration, and gangrene (too often leading to amputation of toe, foot or even leg). Foot deformities such as hammertoes, bunions and metatarsal disorders have special significance in the diabetic population. A deformity places the foot at increased risk for developing corns, calluses, blisters and ulcerations. Neuropathy may render symptoms relatively painless. Special deformities can occur in persons with neuropathy regardless of circulatory condition. A Charcot joint, resulting from trauma to the insensitive foot, causes the foot to collapse and widen. This requires immediate medical attention from your podiatric physician. These conditions do not improve on their own. It is mandatory to seek medical attention as soon as possible.
Common Problems
- Damaged nerves-may make it difficult to feel pain, heat, and cold.
- Blocked blood vessels-bring fewer nutrients to your feet.
- Weakened bones-may slowly shift causing your foot to become deformed.
- Collapsing joints- especially the arch of the foot.
- Broken down skin- caused by too much pressure coming from either the outside or the inside of the foot, can lead to sores or, if bacteria is present, infections.
Foot Surgery in the Diabetic Patient
Realizing the potential danger of foot deformities in the diabetic patient, corrective foot surgery is an option when you are in generally good health and have good circulation. Most deformities progressively worsen over time, as do the effects of neuropathy and vascular or circulatory disease. Diabetic surgery has been performed more frequently in the last few years, as it has shown to present removal of persistent foot problems that often cause devastating consequences to the diabetic. When foot deformities cannot be managed effectively with conservative care, surgery may be indicated. Remember, the best treatment is always prevention.
Advances in the treatment of Diabetic Foot-Looking toward the 21st Century
1. Growth factors--used in the treatment of chronic non-healing ulcerations--ex. RegranexAdvances in antibiotics
2. High tech shoes and orthotic materials
3. More sophisticated surgical treatments with emphasis on limb salvaging
4. Computer technology--gait evaluation, biomechanics, and bone and joint imaging
5. New medications for the treatment of neuropathy
Dr. Marcus' goal is to provide the diabetic with the highest quality care available at this time. He is experienced in the most contemporary methods of Diabetic Wound Care--a subject that is of great importance as we enter the new millennium. With these techniques, he attempts to provide the diabetic with the greatest possibilities of healing and maintaining a functional lower extremity.