Thursday, 22 June 2017

Diabetic Foot Care: Role of a Podiatrist

Diabetes can cause several complaints and conditions like peripheral neuropathy (nerve damage that triggers pain and numbness in feet and hands), foot infection and ulcers, poor circulation (that impairs the body’s ability to heal) and stiffer joints.

In the domain of diabetes management, most patients do not consider foot care as a crucial aspect. They tend largely to leave unattended foot problems, until a serious condition develops. Having a podiatrist in the diabetes management team will help in preventing and managing related foot conditions in the following ways.

Spotting signs of danger early

Due to peripheral neuropathy, people with diabetes are slow to react to cuts, pricks, burns and bruises. They do not feel often any pain or discomfort caused by open sores or bleeding calluses and corns.

During regular scheduled check-ups, a foot doctor can observe such symptoms early and advice prompt treatment, before they worsen to a serious condition. A podiatrist can also notice red flags like skin color changes in the feet, numbness in toes or feet, pain in legs, sores that take too long to heal, swelling in the ankle or feet, ingrown/fungal toenails, dry cracks around heals etc., and prescribe a proper diabetic foot care management required.

Some diabetics may have existing medical conditions like arthritis, which can make foot conditions worse. Having a podiatrist on the diabetes management team in such cases will help address the condition more effectively, and prevent a possible toll on mobility.

Speedy healing of wounds

Injuries and wounds of diabetics often take longer to heal than those of a healthy person. In case the wound stays open, a diabetic is more prone to develop an infection than a non-diabetic is. Such untreated wounds and infections can turn into gangrene, and even infect the bones, increasing the chances of an amputation. However, with the right tips on foot care and treatment of a podiatrist, the wound/injury can heal faster.

Treatment and monitoring of ulceration to avoid amputation

Podiatric management of a diabetic ulcer starts initially with an evaluation of diabetic status and previous treatment history together with a diagnosis of the cause and the stage of the ulcer. A foot doctor examines further, if any infection is present, and the ulcer is ischemic, neuropathic, or neuroischemic.

When treating this vulnerable population, a podiatrist ensures a high level of infection control and plays a crucial role in timely treatment and monitoring of diabetic ulcers to bring down the chances of amputation.  The foot doctor chooses the most suitable cleansing solutions and dressing materials, prescribes topical ointments and uses off-loading techniques that include measures like felt padding, prescription insoles and orthotics.

A multidisciplinary approach is required to treat diabetic foot conditions. It is necessary that an experienced and reputed podiatrist works together with other healthcare professionals; helps in proper screening and assessment of the foot condition; offers timely, effective and speedy treatment; performs biomechanical and gait analysis; provides skilful clinical care; offers foot care education as well as footwear advice.