The Foot Blog
Posts for: November, 2019
Check out the video above of our podiatrists Dr. Robert Pica and Dr. Mitchell Waskin on CBS-6’s Virginia This Morning, talking with Bill Bevins about the importance of diabetic foot health.
Bill Bevins: Did you know that 30 million children and adults in the U.S. have diabetes, and adults over age 65 are more likely to be diagnosed with the disease than any other age group? Foot problems in diabetes can lead to infections, ulcers, and potential amputations. November is American Diabetes Month, and we wanted to bring in podiatrists to talk about the topic. Dr. Mitchell Waskin and Dr. Robert Pica are here this morning. Thank you gentlemen, for coming in this morning.
I remember years ago when dentists used to start checking your mouth for all kinds of stuff, and I’m going, “What are you guys looking at in there?” And they said stuff that happens in the mouth can lead to other things. This — diabetes — can lead to really big problems, can’t it?
Dr. Waskin: Yeah, it can. In fact we try to do an annual diabetic foot exam for all of our diabetic patients, and we look for little things like the condition of the skin, do they have hair on their toes (losing hair on the toes can be an early indication of losing circulation), and we educate them about looking for wounds early, because little problems in diabetics can turn into big problems fast.
Bill Bevins: You deal with wounds a lot, don’t you?
Dr. Pica: Every day.
Bill Bevins: And you brought a couple of samples here that are just as gross as they can be. So, this (holding up foot model #1) would be an early wound on a foot, somebody comes in and says my foot hurts, and you see this?
Dr. Pica: Well, part of the problem is, people don’t see this happening and they can’t feel it. This starts as a callus — about 70% of diabetic foot ulcers start as a callus — so it starts as a callus and then it shears away and reveals the skin beneath.
Bill Bevins: So how long between this, and oh my gosh, this thing here (holding up foot model #2)? This is just amazing to me that that can happen to your toes.
Dr. Pica: So this is on a spectrum; this (referring to foot model #1) would be on one end, and this (referring to foot model #2) is once there’s a severe infection or a lack of circulation and the tissue starts to die, and this is a medical emergency. This patient is going to the hospital, maybe surgery, advanced imaging, a lot of specialists are going to get involved, including vascular surgeons, hospitalists, infectious disease — this is truly a collaborative effort to save that diabetic’s feet — because there are so many things going on that contribute to a situation like this.
Bill Bevins: For that one end of your body to be in that bad a shape, there’s definitely other stuff going on in other places.
Dr. Waskin: There really is. The number one complication of diabetes is foot problems. We hear more about kidneys, eyes, things like that, but it’s feet that put more diabetics in the hospital than anything. Diabetes does affect the circulation, especially below the knee. So these are very common, and a lot of times, until this occurs, people don’t know they have a problem — which is why it’s very important to do preventive care.
Bill Bevins: So how long would a person have to let this go to get to this point, does it depend on how serious the diabetes is?
Dr. Pica: Correct. So, diabetes does a few things. It affects the circulation, and also affects your body’s immune system. It makes those cells sluggish that fight off infection. How well a patient’s diabetes is controlled and how good their circulation is — that determines how quickly it gets worse. It could be a matter of days, weeks or months. I’ve had patients who stepped on something at home, and six months later they’re admitted to the hospital with sepsis because the infection got into their blood.
Bill Bevins: So how can we prevent this from happening, and you say people don’t know they have diabetes — how do we start down this road?
Dr. Waskin: Well, first we start with your primary care physician — get your annual checkups and make sure that you find out if you have diabetes or any other problems, that’s what a good annual checkup is for. And, especially if there’s a family history, and if you are diabetic, then before you have problems, that’s when you want to come see a podiatrist — because, again, the feet are the number one problem area with diabetics. Look at your feet every day — that’s extremely important. If you see minor problems, a little red area that could be an infection, or a small sore — don’t say, “Let me take just care of it myself and throw a little ointment on it and see what happens, and then if it doesn’t heal, I’ll see the doctor” — because things can progress so quickly, you want to come in early.
Bill Bevins: Wow. Great stuff. Thank you both very much.
Our podiatrists at The Foot & Ankle Center are experts in diabetic foot care. If you or a loved one have diabetes, please contact us to schedule you annual comprehensive diabetic foot exam. Just use the button below to request an appointment.