Caring For Diabetic Foot Sores

Remember that the following is just general advice, and you should consult with your primary care physician to determine the best techniques for caring for wounds on your diabetic feet, as they will be able to provide some individualized advice. With that said, don’t be surprised if they recommend some of the following tips.

1. Regular Foot Checks – In order to proactively treat foot sores, you need to be aware of their presence. You may think that the development of a sore will be obvious, but diabetes can also affect the sensation level in your feet, meaning you may not always notice small or newly formed sores in certain spots. Get in the habit of conducting daily foot checks to spot the early onset of any new sores.

2. Clean Them – You can reduce your risk of problematic bacteria entering the wound site by keeping the sore clean. Clean the area with water and then pat dry with a clean cloth. Regularly clean the area and change your bandages so they don’t get damp or dirty.

3. Bandage Them – Many providers recommend you apply antibiotic cream and a bandage to the sore after you’ve cleaned the area. Covering the area with a bandage will help to control drainage and protect the area while it works to heal.

4. Limit Pressure On The Area – Try to limit pressure on the area where the sore is located. This may be easier said than done based on the location of the sore, but avoid tight fitting shoes or consider orthotic inserts to help take pressure off the sore. Additional stress can cause the sore to enlarge, so try to be protective of the area while healing runs its course.

5. Manage Your Blood Sugar Levels – When your blood glucose levels are high, our white blood cells can’t work as effectively at helping to heal the wound site. Poor blood glucose control can also damage blood vessels and decrease circulation, further slowing the healing process. Having healthy blood glucose levels is important for a number of reasons if you are diabetic, including for wound management.

The post How To Care For Wounds On Your Diabetic Feet appeared first on Lance Silverman, MD - Orthopedic Foot & Ankle Surgeon.

Caring For A Diabetic Foot Wound

Caring for a diabetic wound on your feet begins with regular foot exams. Always take a closer look at your feet when you get out of the shower or when you take your socks off at the end of the day. If you notice a new wound or sore has developed, you’ll want to keep the following tips in mind:

1. Keep The Area Clean – Try to keep the area as clean as possible. Wash your hands with soap and water before cleaning the wound with warm water and a cloth. Keeping the area clean is essential for reducing your risk of an infection.

2. Gently Dry The Area – Once you’ve washed and cleaned the area, gently dry it off with a fresh towel or cloth. If washing the area has caused any bleeding or drainage to occur, apply some gentle pressure to the area.

3. Apply Antibiotic Cream – Once the area is clean and dry, you’ll want to further reduce your risk of an infection by applying an antibiotic cream. These creams can help to keep germs out, and the moisture can keep the skin around the wound site from drying out and cracking.

4. Apply A Bandage Or Cover – After the antiseptic has been applied, you’ll want to help keep foreign invaders out of the area by covering it with a bandage or gauze. Your wound will heal best when it is clean, covered and moist.

5. Keep Pressure Off The Area – This is easier said than done if the wound is on the bottom of your foot, but you’ll still want to minimize the amount of pressure you put on the area. Special shoes or orthotic inserts can help to protect the area and provide an ideal healing environment. Talk to your foot specialist if you are wondering how you can best protect a wound on your foot from additional stress while it heals.

6. Maintain Your Blood Sugar Levels – Try to keep your blood glucose levels in check at all times if you are diabetic, but that’s especially true while your body is attempting to divert resources to help the foot wound heal. Foot ulcers and sores will only become more common if you don’t do a good job of managing your blood sugar levels.

If you an keep all of the above tips in mind, and you work with a doctor who specializes in helping treat diabetic foot issues, you will be able to increase your chances of experiencing a fast recovery.

The post How To Care For A Diabetic Sore On Your Feet appeared first on Lance Silverman, MD - Orthopedic Foot & Ankle Surgeon.

Diabetic Foot Ulcers

For the study, the team of researchers reviewed data on more than 124,000 patients with diabetic foot ulcers who were hospitalized in 2013 and 2014. They found that overall, the group had a 17.6% rate of major amputation or death. However, Black patients had a 21.9% rate of major amputation or death related to diabetic foot ulcers, a 4.3% disparity. Other findings from the study include:

• Those living in rural areas had a 0.7% increased risk of death or amputation.
• The amplified effect for Black people living in rural areas was not the sum of the two percentages (5%), but rather an increase of 10.4% in death or amputation risk.

“When you actually look, they have a more than 10% increased risk, doubling what we would have expected,’’ said Dr. Meghan Brennan, an infectious disease physician and lead author of the study. “They are undergoing major amputations at a rate that is much higher than it should be. Disparities happen in medicine and we need to recognize them before we can begin to address them.”

Although researchers stopped short of pinpointing exactly why the disparities exist, Brennan surmised that the results could be indicative of weak points in the ambulatory health and triage care systems, and the fact that vascular surgeons and wound salvage teams are not as plentiful in rural areas. No matter where you live, prevention and early intervention are key if you are diabetic and are at risk for foot ulcer formation.

We share a number of tips for caring for your diabetic feet on our blog and website, and we always talk with our diabetic patients about the importance of improved foot health as they manage the totality of their condition. A small sore may not seem like a big deal, but if diabetes complicates blood flow and the wound can’t heal, it can turn serious in a hurry.

The post Racial Disparities Still Exist For Diabetic Foot Ulcer Care appeared first on Lance Silverman, MD - Orthopedic Foot & Ankle Surgeon.

According to researchers out of the University of Southern California, the “foot selfie” may soon become a helpful tool in identifying potential diabetic foot issues so that they can be treated before they become worse. As we’ve documented on the blog in the past, conducting regular foot checks is important if you have diabetes to help spot signs of a problem. The only issue is, checking our feet thoroughly isn’t always an easy task.

That idea led Mark Swerdlow, a fourth-year medical student at USC, to build a simple 3D printable device that allows patients to take standardized photos of the entire bottom surface of their own feet. Best of all, the accompanying phone app works through voice commands, so patients don’t need to bend over to reach the photo button. They can simply get their foot in the right position and command the app to take a picture with the sound of their voice.

“The point of it is to be a very simple tool that essentially anybody can use,” Swerdlow said of the “Foot Selfie System.”

So Far, So Good

The Foot Selfie system consists of a heel platform, a smartphone holder and a base that connects the pair via telescoping rods. The accompanying app, available on iOS and Android, shows people how to take voice-activated photos, which can then be viewed or sent to a protected storage server to be reviewed by healthcare providers. And if a patient forgets to take their foot selfie, the app reminds them after 24 hours has passed.

The post Could “Foot Selfies” Help Prevent Diabetic Foot Problems? appeared first on Lance Silverman, MD - Orthopedic Foot & Ankle Surgeon.

Because of this, we’re excited to help spread the word about Diabetes Awareness Month on our blog and with the help of the American Orthopedic Foot & Ankle Society. As you may know, I sit on the Communications Cabinet of the AOFAS, and they are also working to spread awareness about diabetes and the toll it can take on your feet. Here’s a press release they created to help spread awareness of National Diabetes Awareness Month.

AOFAS Press Release

The post November Is National Diabetes Awareness Month appeared first on Lance Silverman, MD - Orthopedic Foot & Ankle Surgeon.

The numbers were reported by the digital health tracking platform Glooko, a web and mobile application that tracks blood glucose levels among more than 1.5 million users across 23 different countries. After looking at the collective data of their users, researchers uncovered that Valentine’s Day was the worst day for users in terms of keeping their blood glucose levels in a healthy range. Here’s a look at the average blood glucose levels on some of the worst days in the calendar year:

• Valentine’s Day – 168 mg/dL (9.3 mmol/L)
• Halloween – 158 mg/dL (8.8 mmol/L)
• Christmas Day – 140 mg/dL (7.8 mmol/L)
• New Year’s Eve – 131 mg/dL (7.3 mmol/L)

Michelle de Haaff, Glooko’s vice president of Strategy, said Valentine’s Day is so problematic for diabetics because of the regular opportunities to snack on chocolate and because many people go out to eat for dinner.

“Valentine’s is known to be a sugary holiday where chocolates are given as gifts and people go out for meals. It is likely that is what drives higher glucose,” said de Haaff.

Diabetic Care on Valentine’s Day

So if you are diabetic or pre-diabetic, we want to share some tips for helping you navigate Valentine’s Day and other holidays. For starters, eat and drink in moderation. And by moderation, we don’t mean just one piece of chocolate every time you come into the break room. One or two pieces are fine with lunch or dinner, but don’t snack on these sugary sweets throughout the day. Other tips to help keep your blood glucose levels in check include:

• Fill up on healthier options so you’re not tempted to overindulge with sweets.
• Drinking plenty of water can help you feel full.
• Try to carve out 30-45 minutes to exercise.
• Limit your alcohol consumption during dinner.
• Monitor your blood glucose levels throughout the day.

The post Valentine’s Day and Your Diabetic Feet appeared first on Lance Silverman, MD - Orthopedic Foot & Ankle Surgeon.

The technology is still in its infancy, but it’s producing some successful results. According to the research, the temperature-monitoring foot mat was able to correctly detect 97 percent of impending nontraumatic diabetic foot ulcers in a high-risk population

“We showed that using this wireless mat and an algorithm that detects temperature rise over several days, it is possible to detect development of an ulcer 5 weeks in advance,” reported Robert Frykberg, DPM, podiatrist at Phoenix VA Healthcare System, Arizona, and lead investigator of the study.

Benefits of Temperature Monitoring

When you suffer an injury, you may notice that the injured area is a little warm to the touch. This warming sensation occurs because blood vessels dilate as more blood is brought to the site. A similar process occurs in diabetic foot ulcers, but this change in temperature happens before the ulcers fully develop on the foot. By checking for heat spikes or temperature abnormalities, researchers have been able to predict the onset of ulcers before they develop on a person’s foot, which aids in treatment and reduces severity and likelihood of problems.

Medical experts have been aware of this temperaure change in a person’s foot, and current US guidelines for diabetic foot care suggests daily thermometry of the foot, but there hasn’t really been a good way to track the temperature of an area of a foot or changes in temperature, so few diabetics and doctors rely on the insight when it comes to foot care. That may soon change with the development of the temperature-mapping foot mat.

The technology is relatively simple yet ingenious at the same time. The wireless floor mat requires the patient to stand still for 20 seconds each day. The mat reads the temperature of the person’s feet in a number of different areas to obtain plantar-temperature mapping data which is then cataloged in a monitoring center. A program studies the map, and by comparing it to previous readings, it can predict the onset of diabetic foot ulcers with high certainty.

“Essentially, the mat detects areas of increased inflammation that often precede ulceration,” explained Dr Frykberg. “It has been shown, in this and other studies, that when this device is used with early intervention, it can very likely reduce the development of recurrent ulcers.”

One Drawback

However, there is one drawback with the technology in its current form. Although it accurately predicted the onset of diabetic foot ulcers in 97 percent of instances where an ulcer eventually formed, it also had a 57 percent false-positive rate. So while the vast majority of ulcers are being identified by the machine, it’s also currently flagging a number of areas that don’t turn out to be ulcers. It’s better to be safe than sorry, but researchers will need to reduce that high false positive rate if the device is going to gain widespread attention.

“The standard temperature difference used was 2.22°C, but we can probably become more specific with new algorithms to eliminate many of these false positives.”

The post New Tool May Help Predict Diabetic Foot Ulcers appeared first on Lance Silverman, MD - Orthopedic Foot & Ankle Surgeon.

In a first-of-its-kind study, researchers decided to see if cognitive function was affected by the development of diabetic foot ulcers. For the study, researchers recruited 194 study participants between the ages of 45 and 75 years old. 99 patients had at least one diabetic foot ulcer, while 95 diabetics without foot ulcers made up the control group. Each person underwent a battery of neuropsychological tests that examined: General intelligence, short- and long-term memory, attention and concentration, psychomotor efficiency, reaction time, executive function, nonverbal IQ, visual-motor speed, coordination, capacity for learning, verbal production, semantic memory, and language.

Diabetic Foot Ulcer Study

After comparing the scores between groups, researchers uncovered that patients with diabetic foot ulcers showed significantly lower scores in all the tested fields compared to patients without foot ulcers.

Diabetics who had developed foot ulcers “remember less, have decreased ability to concentrate, and more difficulty with learning, less inhibition, slower cognitive and psychomotor responses, and less verbal fluency” than diabetics without the foot condition, the researchers wrote.

The research is beneficial because it can help doctors better treat diabetics who develop foot ulcers. Knowing that cognitive decline may be associated with foot ulcers can lead to more focus on cognitive therapy alongside ulcer treatment.

“We feel that it is important to screen the cognitive status of these patients regularly and to take cognitive abilities into consideration in treatment-planning recommendations and follow-up,” researchers wrote.

Researchers said the test didn’t prove that foot ulcers caused cognitive decline, only that there was a correlation between foot ulcer development and lower cognitive scores. The team of researchers hope to conduct subsequent studies to determine causation and to pinpoint when cognitive function begins to taper off when a foot ulcer develops.

The team concluded by saying that the study findings “highlight the importance of focusing on cognitive functioning, a less-studied area in diabetic foot research.

So if you want to keep your mind sharp, pay attention to your feet. For more information on ways to protect your diabetic feet, check out this webpage we created on the caring for your diabetic feet!

The post Diabetic Foot Ulcers Linked To Cognitive Decline appeared first on Lance Silverman, MD - Orthopedic Foot & Ankle Surgeon.

In a first-of-its-kind study, researchers from Israel’s Ben Gurion University examined brain functionality in diabetic patients both before and after they developed an ulcer in their foot. Researchers looked at 99 patients with diabetic foot ulcers as well as a similar sized control group.

When compared to diabetic patients who did not develop ulcers, those who did develop foot ulcers expressed:

• Reduced concentration

• Worse memory

• Learning and comprehension difficulty

• Delayed motor responses

• Reduced inhibition

• Decreased verbal fluency

Researchers noted that previous studies on complications from diabetes have found a link between the condition and cognitive decline, but the new findings suggest that foot ulcers may speed up that impairment due to micro- and macro-vascular changes that occur when the ulcers develop. Those changes may have significant effect on a number of organs, including the brain.

“This study demonstrates that ‘diabetic foot’ refers not only to a physical condition but rather to a more generalized complex state involving significant cognitive changes as well,” said lead researcher Dr. Rachel Natovich.

Dr. Silverman Comments

We’ve known that diabetes has been linked to numerous other health conditions, like heart disease, hypertension and stroke, but this study shows that it also may have a significant effect on a person’s mental well-being. Being diagnosed with a health condition like diabetes or cancer will certainly have an effect on your mental health, but this study showed that when compared to others with diabetes, it was the patients with foot ulcers that saw a measurable cognitive decline.

It’s an interesting study, and I hope they continue to do more research on the association between foot ulcer development and cognitive decline. At the moment, the study stands as another reason to take good care of your feet.

The post Foot Ulcers Negatively Affect Brain Functionality appeared first on Lance Silverman, MD - Orthopedic Foot & Ankle Surgeon.

Your feet are not immune to complications from diabetes. In fact, it’s estimated that one in four people will develop an issue with their because due to their diabetes. That said, there are some things you can do to help keep your feet healthy while you’re managing your diabetes.

In an effort to keep people healthy, Texas Health Resources put together this handy infographic to help showcase how to care for your feet if you have diabetes. Check out the infographic below, and please take care of your feet!

The post Diabetic Foot Guide: What Your Need To Know appeared first on Lance Silverman, MD - Orthopedic Foot & Ankle Surgeon.