Diabetes and Your Feet

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Diabetes and Your Feet

• A Brief Overview

Dr. John Kadukammakal, DPM, AACFAS
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Background

• Born raised in Philadelphia, PA.
• Medical School _at_ Temple University
• 3 year surgical training at Crozer Keystone
  Health System in Chester, PA.
• Office Location
• Richmond Medical Park
• 2008 Bremo Road Suite 100, Richmond, VA. 23226
• 804-285-3933

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Diabetes Statistics (2011)

• Nearly 25.8 million people, or 8.3 of the U.S.
  population, have diabetes
• 18.8 million people have been diagnosed
• 7 million people are still undiagnosed

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Categories of Diabetes

• Type 1 (Insulin Dependent)
• Type 2
• Non-insulin Dependent
• Diet Controlled
• Pre-Diabetic ???

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Diabetes A Systemic Issue

• Not only affects your blood sugar level
• Affects major organs
• Brain
• Heart
• Kidneys
• Eyes
• Feet!!!!!

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Diabetes the Feet

• Diabetes can cause
• Delayed Healing
• Lower Extremity Edema (Swelling)
• Also seen with HTN, Kidney Issues, Venous
  Insufficiency
• PVD (Peripheral Vascular Disease)
• Wounds/Ulcers
• Charcot Deformity

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Prevalence of Ulcers

• Up to 25 of those with diabetes will experience
  an ulcer or wound at some point.
• Amputation rates can be reduced by 45 to 85
  with a comprehensive foot care program.
• Without proper treatment, ulcers can quickly
  escalate into amputation.

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Diabetic Foot Wounds
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Diabetic Foot Wounds
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Charcot Foot

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Charcot Foot

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Diabetic Neuropathy

• Disease of the nerves in legs and feet
• Cause nerves to misfire miscommunicate
• Can result in burning, tingling, electric
  shocks, bee-stings
• Can happen if blood sugar is high or normal
• Can be treated with good sugar control and
  medication if needed

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What is a Podiatrist?

• A specialist trained to treat and manage
  disorders of the foot and ankle.

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Job of a Podiatrist

• Perform thorough Foot Examinations
• Check circulation, sensation, etc.
• Trim toenails, corns, calluses
• Correct foot/ankle deformities either surgically
  or conservatively
• Hammertoes, Bunions, Flat feet, etc.
• Manage Neuropathy

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When to see a Podiatrist?

• For any foot/ankle problems
• If Diabetic controlled
• At least twice a year
• If Uncontrolled Diabetic
• Every 3 months

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Pedicures

• Are they wrong?
• What should I get done?
• What to look out for?

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Shoe gear

• What kind is the best?
• Depends on the level/type of activity
• What to look for in a shoe?
• Are flip-flops bad?

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Diabetic Shoes

• Shoes that are wider and deeper than regular
  shoes
• Inserts are made from mold of your feet
• Come in a wide variety of styles
• One pair per calendar year is covered by
  Medicareand some private insurances

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Diabetic Shoes
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How To Manage Your Feet

• Perform Daily Foot Inspections
• Moisturize twice a day (except in between your
  toes)
• Coco Butter, Nivea Cream, Eucerin Cream,
  Lubriderm
• Do not walk barefoot!!!
• No bathroom surgery!!!!
• Socks (white cotton)
• Inspect Shoes rotate them
• COMMON SENSE!!!!