Diabetes can cause foot ulcers that threaten limbs, but there are steps you can take to mitigate your risk.
R. Daniel Davis, D.P.M.
Past President, American Podiatric Medical Association
Diabetes is the fastest growing disease in the United States. The Centers for Disease Control and Prevention predict that by 2050, 1 out of 3 Americans will be diabetic.
Anywhere from 1 in 4 to 1 in 6 of those patients will get an ulcer, which is an open sore or wound, typically on the bottom of the foot. Without the proper care, ulcers can lead to infection and amputation.
Patients who suffer a below-knee amputation have a 68 percent five-year mortality rate. That’s higher than the five-year mortality rate for breast cancer, prostate cancer, and non-Hodgkin’s lymphoma combined.
As a podiatrist, one of my most important jobs is to treat those ulcers and help patients avoid amputations.
Evolving care
We’ve seen a lot of evolution in wound care. There have been incredible advances in the products we use to treat serious diabetic wounds. We have products that include stem cells, which differentiate into muscle, tendon, bone, fat, and skin. They also stimulate the growth of blood vessels, which is critically important, because good blood flow promotes healing.
Another important factor in diabetic wound care is biomechanics — simply put, the mechanics of human movement. When an ulcer — or an amputation — changes the way a person moves, those changes put stress on other parts of the body and can cause wounds to develop on other areas of the feet. Podiatrists evaluate a patient’s biomechanics to help prevent more wounds from developing and help existing wounds heal.
Save the toe
Some physicians might say, “It’s just a toe, take it off.” Don’t ever say that within 50 miles of me. My philosophy is simple: If you save the toe, you save the foot; if you save the foot, you save the leg; if you save the leg, you save the life.
If you have diabetes, have a regular foot exam with a physician. Check your feet daily or, if you can’t, ask a loved one for help or use a mirror. If you notice any change in your feet, see your podiatrist immediately.
Diabetes is not going away in our lifetimes, but with the proper care team and personal vigilance about changes in your health, you can manage your diabetes and prevent some of its most serious complications.