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Saving Legs One Foot at a Time

November 20th, 2019

Diabetic foot ulcers are one of the most common complications of diabetes, but the condition doesn’t always get the attention it deserves. Diabetic foot complications are responsible for more hospitalizations than any other complication from diabetes – and many amputations are preventable. 

“Just like heart disease or stroke, diabetes and associated complications like foot ulcers are urgent problems that many people are facing – and delay in treatment can lead to a person losing a toe, foot or even their leg,” says Karen Rudolph, M.D., vascular surgeon with University Surgical Associates

Diabetic ulcers are open sores on the foot – usually circular in nature – and occur commonly on the toes or heels although they can be present anywhere on the foot. They can develop because of cuts, blisters and sometimes callus formations that turn into ulcers. According to Dr. Rudolph, many people don’t realize how serious even a small injury to the foot can be for a person with diabetes. A tiny scratch can develop into a major ulcer and spreading infection that can ultimately require amputation if not caught early enough. 

“Overall diabetics have approximately a 25% chance of developing a foot ulcer at some point in their lifetime,” says Sachin Phade, M.D., vascular surgeon with University Surgical Associates. “A diabetic foot ulcer is a pivotal event in the life of person with diabetes and a marker for other serious medical problems. Without early and optimal intervention, the sore can rapidly deteriorate leading to amputation.”  

Neuropathy is to Blame 

Many people with diabetes experience neuropathy, a condition that causes numbness or weakness in their extremities. Individuals with neuropathy are at greater risk of developing ulcers and other foot problems. Losing sensation and feeling in the feet and legs makes it very easy for a sore or scrape on the foot to go unnoticed until it’s a major problem. That’s why people with diabetes should examine their feet daily to watch out for any changes. This includes the top and bottom of the feet and in between their toes. 

“I’ve had patients who have walked around with a nail in their shoe, resulting in a terrible injury to their foot – and they didn’t know it had happened,” says Dan Fisher, M.D., vascular surgeon with University Surgical Associates. “Others see a tiny black spot, and because they can’t feel it, don’t think it’s serious enough to seek care. The opposite is true. Any skin breakdown should be examined by a primary care physician or podiatrist immediately.”  

Effective Treatment 

Certified vascular surgeons like those at University Surgical Associates are the professionals best suited to treat the complicated vascular problems associated with diabetes. Without proper circulation, diabetic ulcers will not heal and risk having an amputation. “A full evaluation including an exam and frequently a blood flow test is used to determine if circulation is inadequate in the legs and feet,” says Mark Fugate, M.D., vascular surgeon with University Surgical Associates. “To restore proper circulation, correction can be performed through small catheters and placement of stents that open up blood flow. We also remove plaque buildup in the arteries, and in some cases, a bypass is necessary to save a person’s leg.” 

Early Intervention is Critical 

The majority of amputations are preventable with appropriate care, and that begins with patient education about the importance of controlling blood sugar, eating an appropriate diet, smoking and alcohol cessation, and seeing a physician regularly. Dr. Fugate recommends that people with diabetes see their family physician or podiatrist three to four times a year. Many need corrective foot ware or inserts to keep from rubbing a blister that can lead to more serious problems. 

“Any inflammation or swelling on any part of the foot, any sign of infection like redness or drainage, any unexplained pain or black areas on any part of the foot are reasons you should see a provider as soon as possible,” he says. “Over the years I’ve seen many diabetic foot problems, and too many patients have needless amputations. With proper intervention, we can effectively treat these conditions and help people live longer and with a better quality of life.”   

University Surgical Associates provides advanced care for people with diabetic wounds and the other vascular issues associated with diabetes. To schedule an evaluation, call (423) 267-0466. 

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