Why is foot health so important for diabetics?

HOT SPRINGS, S.D. – November is National Diabetes Month, an initiative designed to bring awareness to diabetes and the practical ways to manage symptoms. Sylvia Trotter, podiatrist and acting chief of staff at Fall River Health Service Hospital, shared her insight on diabetes and podiatric manifestations of diabetes. Dr. Trotter has been in practice for 24 years; the past 2 years at Fall River Health Services.

 What is podiatry?

“Podiatry is the treatment of the foot and the structures connected to it. For example, tendons from muscles in the legs are relevant to podiatry. I practice a more conservative approach, so I treat general foot aches and pains, minor injuries, skin and toenail conditions. I do some wound care as well. If needed, I’ll order orthotics or braces to help support the foot.”

 Why is podiatry important?

“Podiatry is important because it helps keep people active. Whenever there’s a foot issue, it tends to impact the rest of the person’s health because they don’t stay as active.”

What causes podiatric problems?

“There are acute injuries as well as more gradual changes that can cause foot-related problems.  The gradual changes are often due to the impacts of disease, foot structure – which is determined by genetics and can cause abnormal strain on the structure of the foot, or due to wear and tear – such as from minor injuries over time.”

How does diabetes contribute to poor podiatric health?

“Diabetes can have an impact on the feet by primarily by changing circulation or sensation. A person with diabetes can have decreased circulation in the skin and the soft tissue. High blood sugar can also cause damage to the nerves, which interrupts the signal from that area of the body to the brain. This process is called peripheral neuropathy.”

What are some podiatric symptoms that can occur in a person with diabetes?

“With peripheral neuropathy, the person may notice a burning, stinging type pain in the feet or numbness in part or all of the feet. Poor circulation may cause a reddish or purplish color change to the skin, a loss of hair on the feet and toes, or difficulty healing a small cut or blister. Having both numbness and poor circulation can result in injury to the feet without the person realizing it. This may be minor injury such as a toe rubbing on the shoe, or major such as stepping on a nail. Most of us don’t go to the doctor unless we have pain. So without that protection of pain, foot problems can really progress before the person realizes there’s a problem. That’s what causes the risk of amputations in diabetics.”

What are some things people with diabetes can do to avoid long-term, serious podiatric issues?

“In general, people with diabetes should have their feet checked annually. During that exam, we will check for circulation and sensation. This helps the provider and the patient both better understand the patient’s risk level and understand how much we can rely on their perception of pain. Also, they should watch for calluses on the feet, red areas or hot spots on the feet, a change in the shape of the toes or feet, unexplained swelling, or a sore on the foot that is not healing as expected. Any of those things should be checked out right away.”

Are there regions in the country with patients who seem more prone to diabetes and podiatric issues associated with diabetes?

“I would say this area is pretty typical to other rural areas I’ve worked. In order to survive and thrive in rural areas, people tend to be more self-reliant and this can spill over into their health care as well. They may be more prone to trying things at home to fix whatever they believe ails them. So, sometimes it takes more encouragement and education in the rural areas to help people understand why they should seek care rather than trying to manage things themselves.”

What services can Fall River Health provide for patients managing diabetes?

“We have a team of primary care physicians who can help the patient control their blood sugar; podiatry to aid with foot care; a dietitian that can help with understanding and improving nutrition and weight loss. Better blood sugar control will decrease the long-term impacts caused by diabetes and result in a better quality of living.”

What are some practical habits patients with diabetes can implement to reduce their risk of podiatric issues?

“They should moisturize the skin on their feet, more than what they perhaps previously did, because diabetes can decrease the natural hydration. They shouldn’t cut out their calluses with anything sharp or use any medicated corn pad removers that could break down the normal skin if it slips during the day into the wrong spot. They should protect their feet with correctly fitting shoes. Also, feet should be kept warm with socks or blankets rather than use of heating pads or by propping them up by the fire.” For more information, call Fall River Health Services at (605) 745-8910 or visit their website here.


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