What is the role of a podiatrist in diabetes foot care?

Dr. Hillary B. Brenner, DPM
Podiatrist (Foot Specialist)

Each year more than 65,000 lower limbs are amputated due to complications from diabetes. By including a podiatrist in your diabetes care you can reduce the risk of lower limb amputation by up to 85%. Podiatrists play an integral role in amputation prevention by performing regular foot screenings and early recognition. For example, a podiatrist will look for the following diabetes warning signs: 1) Dry cracks in the skin; 2) Ingrown and fungal toenails; 3) Numbness in the feet or toes; 4) Open sores on the feet that are slow to heal; 5) Swelling of the foot or ankle; 6) Pain in the legs; 7) Skin color changes; and 8) Bleeding corns and calluses.

Podiatrists graduate from a college of podiatry with a Doctor of Podiatric Medicine (DPM) degree. They also complete residencies in podiatry and can perform surgery and prescribe medication for your feet. Podiatrists treat corns, calluses, and foot sores to prevent more serious problems from developing. They can also show you how to correctly trim your toenails and how to buy shoes that fit properly. To find a podiatrist, ask your diabetes care provider for a referral, or check with local hospitals or your local ADA office. During your initial visit, ask what percentage of his or her patients have diabetes.

Dr. James Christina
Podiatrist (Foot Specialist)

Podiatrists play a key role in providing appropriate foot care for people with diabetes. A person with diabetes should have a comprehensive diabetic foot examination by a podiatrist on a yearly basis. Depending on the findings on the comprehensive diabetic foot examination based on the risk status of the person, a regular schedule of foot care should be set up. For those persons with diabetes and no risk--yearly foot examinations are fine. For others, depending on their risk status they may need to be seen more frequently. This is the basis for regular scheduled examinations and foot care, but any acute problems should be evaluated immediately. The greatest danger is for those with diabetes that have lost the ability to sense pain in other words they have the loss of protective sensation (peripheral neuropathy). These persons need to be extremely careful and have their feet inspected daily by themselves or a family member to look for any areas of redness, irritation, cuts or sores.

Podiatrists are an important member of the team of providers providing care for people with diabetes. Studies have established that including podiatrists in the care of people with diabetes leads to less lower extremity complications. Prevention is essential in preventing serious diabetic foot problems.

Dr. Nadia F. Levy, DPM
Podiatrist (Foot Specialist)

The role of a podiatrist in diabetic foot care ranges from regular prevention and education to identifying and treating problems before they get out of hand. In the extreme cases, it can be about helping control an infection and attempting to save a limb.

The role of a podiatrist in diabetic foot care is to be a patient's advocate and to monitor the health of their feet.

Every person with diabetes should pay careful attention to the systems of the body diabetes can directly and adversly affect: the cardiovascular system, the renal system (kidneys), the eyes, and the feet. It is recommended that every patient with diabetes have at least an annual check on all of these systems.

As far as the feet are concerned, people with diabetes can have severe, even life-threatening foot problems. This can happen because of a snowball effect that diabetes can cause to the circulatory and nervous systems of the body. Essentially, diabetes can cause:

  • decreased foot bloodflow
  • decreased healing potential
  • decreased infection fighting capability
  • numbness of the feet

These problems can all come together in a diabetic foot causing drastic results.

It is entirely possible, for example, that a diabetic could step on a nail, and being numb, not even know it. Then follows a severe infection (which he may not be able to fight), decreased healing potential, decreased bloodflow, and problems can spiral quickly. Often this patient may not even realize he stepped on a nail for a few days, by then a severe infection has set in and the problem is serious.

Every diabetic should have a foot doctor, and patients who are numb in the feet should see their foot doctor on a regular basis, often five to six times/year. These problems are preventable and are not inevitable. Regular check-ups with a podiatrist can prevent problems. Insurance plans will pay for regular diabetic foot check-ups, as well as nail trimming and callus trimming, and sometimes even diabetic shoes.

Dr. Curtis C. Pedersen, DPM
Podiatrist (Foot Specialist)

Diabetes affects the lives of nearly 26 million people in the United States and nearly seven million don’t even know they have the disease yet.

Podiatrist plays a key role in helping patients manage diabetes successfully and avoid foot-related complications and are an important part of your diabetes management team.

The keys to amputation prevention are early recognition and regular foot screenings performed by a podiatrist.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.