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The Effects of Diabetes on Our Feet
Dr. Craig Jex explains the affect diabetes has on our feet.
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Learn more about Craig Jex, MD, DPM
Craig Jex, MD, DPM
Craig Jex, MD, DPM works in partnership with patients, offering high-quality, and individualized care with compassion. He believes communication and collaboration with patients is the foundation for effective relationships.Learn more about Craig Jex, MD, DPM
Transcription:
The Effects of Diabetes on Our Feet
Bill Klaproth (Host): Diabetes can lead to many different complications including your feet. Diabetic foot ulcers and infections are a common problem, so what do you need to know about diabetic foot ulcerations and infections? Let’s find out with Dr. Craig Jex, a podiatrist at Dignity Health. Dr. Jex, thank you for your time. First off, can you tell us how diabetes affects our feet?
Dr. Craig Jex (Guest): Well the diabetes is a condition where patients have a higher than normal amount of blood glucose – or blood sugar that circulates in their blood. The high blood sugar is toxic to the nerves in the feet, which causes numbness. There’s a lot of theories about why that occurs, but the higher than average blood sugar causes damage to the nerves that provides sensation to the feet and also affects circulation. This combination makes people more prone to developing sores on the foot from pressure areas. The sores can become infected. The infection can spread to the bone and then sometimes unfortunately that can lead to amputation, so obviously prevention becomes pivotal.
Host: So let’s talk about that, speaking of prevention, how can someone prevent these complications from diabetes happening?
Dr. Jex: Yeah that’s a great question. The number one way is to control blood sugar. Maintaining a tight control over their blood sugar is by far the number one way to prevent the numbness from occurring in the first place and if it started to try to prevent that from worsening and that goes with all of the complications from diabetes for the most part. In addition to tight blood sugar control, monitoring their feet closely, meaning checking top and bottom, at least once daily, looking for any break in the skin, redness, swelling, blisters, anything along those lines and they would want to tell a doctor or podiatrist immediately if any of those are noted so that if something occurs, the treatment can start right away.
Host: Got it, so seek medical attention right away. So then what are the nonsurgical treatment options for someone suffering from one of these diabetic conditions?
Dr. Jex: There are multiple. As a podiatrist when I first see a patient with a diabetic ulceration or a diabetic sore, we check their circulation, multiple ways to do that to make sure that the amount of blood flow getting to the foot is adequate to heal the sore. We’ll make sure it’s not infected both through physical exam or diagnostic testing, imaging, things along those lines and there’s different ways we use to keep the pressure off the ulcer. Getting pressure off the sore is very important to allow that to heal and then different modalities we have different wound care products or even synthetic skin grafts that we can put on, things along those lines to get the ulceration to heal prior to any infection setting in, but the key points to that are ensuring there’s adequate blood flow to the foot, keeping pressure off that area, assuring that it’s not infected, and then also removing any nonviable or healthy tissue from the ulcer site, a process called debridement where we take the dead tissue off and then leave the healthy tissue behind.
Host: So when is a surgical option called for?
Dr. Jex: It depends somewhat on the patient, whether they’re a surgical candidate and what type of ulceration it is. The guidelines we typically follow are, if the ulceration is not infected and is not threatening the foot or the leg, then we usually wait several weeks and try other things before entertaining any surgical intervention. If we go several weeks without healing, then there’s different procedures that can be done to try to internally take the pressure off that area so to speak. Obviously if the ulceration becomes infected or it’s threatening the leg or the limb then you have to be more aggressive right away with surgical intervention.
Host: What if someone doesn’t call the doctor right away and says, “I’m just going to live with this. I’m just going to deal with the pain and live with this for a while.” What happens then if someone doesn’t get this treated?
Dr. Jex: Unfortunately in that situation it can lead to loss of either part or all of the foot, the whole reason we do diabetic preventative limb salvage would be to try to prevent below the knee or above the knee amputation, so avoiding treatment or trying to treat it on your own is something that could be fairly disastrous.
Host: So don’t try to treat it on your own. That sounds like it’s really important and make sure you call the doctor right away. Earlier you were mentioning some ways to prevent complications. Overall are there any lifestyle changes someone can do to try to prevent these complications from happening?
Dr. Jex: Well obviously diet and exercise in conjunction with medication to control their blood sugar, different shoes that we’ll put patients in to try to offload the area after we get it healed to prevent recurrence, things of that nature, but as I discussed earlier, a lot of it comes down to blood sugar control which in addition to medications would be exercise and appropriate diet.
Host: So blood sugar control, exercise, and diet. Lastly Dr. Jex, is there anything we should know about diabetic foot ulcerations and infections?
Dr. Jex: Only that it’s a very significant problem and any indication that, that’s occurring then they should see a professional right away.
Host: Well said and thanks Dr. Jex. To learn more and to get hooked up with one of our providers, visit dignityhealth.org/bakersfield/woundcare and if you liked what you’ve heard, please share it on your social channels and be sure to check out our full podcast library for topics of interest to you. This is Hello Healthy, a Dignity Health podcast. I’m Bill Klaproth, thanks for listening.
The Effects of Diabetes on Our Feet
Bill Klaproth (Host): Diabetes can lead to many different complications including your feet. Diabetic foot ulcers and infections are a common problem, so what do you need to know about diabetic foot ulcerations and infections? Let’s find out with Dr. Craig Jex, a podiatrist at Dignity Health. Dr. Jex, thank you for your time. First off, can you tell us how diabetes affects our feet?
Dr. Craig Jex (Guest): Well the diabetes is a condition where patients have a higher than normal amount of blood glucose – or blood sugar that circulates in their blood. The high blood sugar is toxic to the nerves in the feet, which causes numbness. There’s a lot of theories about why that occurs, but the higher than average blood sugar causes damage to the nerves that provides sensation to the feet and also affects circulation. This combination makes people more prone to developing sores on the foot from pressure areas. The sores can become infected. The infection can spread to the bone and then sometimes unfortunately that can lead to amputation, so obviously prevention becomes pivotal.
Host: So let’s talk about that, speaking of prevention, how can someone prevent these complications from diabetes happening?
Dr. Jex: Yeah that’s a great question. The number one way is to control blood sugar. Maintaining a tight control over their blood sugar is by far the number one way to prevent the numbness from occurring in the first place and if it started to try to prevent that from worsening and that goes with all of the complications from diabetes for the most part. In addition to tight blood sugar control, monitoring their feet closely, meaning checking top and bottom, at least once daily, looking for any break in the skin, redness, swelling, blisters, anything along those lines and they would want to tell a doctor or podiatrist immediately if any of those are noted so that if something occurs, the treatment can start right away.
Host: Got it, so seek medical attention right away. So then what are the nonsurgical treatment options for someone suffering from one of these diabetic conditions?
Dr. Jex: There are multiple. As a podiatrist when I first see a patient with a diabetic ulceration or a diabetic sore, we check their circulation, multiple ways to do that to make sure that the amount of blood flow getting to the foot is adequate to heal the sore. We’ll make sure it’s not infected both through physical exam or diagnostic testing, imaging, things along those lines and there’s different ways we use to keep the pressure off the ulcer. Getting pressure off the sore is very important to allow that to heal and then different modalities we have different wound care products or even synthetic skin grafts that we can put on, things along those lines to get the ulceration to heal prior to any infection setting in, but the key points to that are ensuring there’s adequate blood flow to the foot, keeping pressure off that area, assuring that it’s not infected, and then also removing any nonviable or healthy tissue from the ulcer site, a process called debridement where we take the dead tissue off and then leave the healthy tissue behind.
Host: So when is a surgical option called for?
Dr. Jex: It depends somewhat on the patient, whether they’re a surgical candidate and what type of ulceration it is. The guidelines we typically follow are, if the ulceration is not infected and is not threatening the foot or the leg, then we usually wait several weeks and try other things before entertaining any surgical intervention. If we go several weeks without healing, then there’s different procedures that can be done to try to internally take the pressure off that area so to speak. Obviously if the ulceration becomes infected or it’s threatening the leg or the limb then you have to be more aggressive right away with surgical intervention.
Host: What if someone doesn’t call the doctor right away and says, “I’m just going to live with this. I’m just going to deal with the pain and live with this for a while.” What happens then if someone doesn’t get this treated?
Dr. Jex: Unfortunately in that situation it can lead to loss of either part or all of the foot, the whole reason we do diabetic preventative limb salvage would be to try to prevent below the knee or above the knee amputation, so avoiding treatment or trying to treat it on your own is something that could be fairly disastrous.
Host: So don’t try to treat it on your own. That sounds like it’s really important and make sure you call the doctor right away. Earlier you were mentioning some ways to prevent complications. Overall are there any lifestyle changes someone can do to try to prevent these complications from happening?
Dr. Jex: Well obviously diet and exercise in conjunction with medication to control their blood sugar, different shoes that we’ll put patients in to try to offload the area after we get it healed to prevent recurrence, things of that nature, but as I discussed earlier, a lot of it comes down to blood sugar control which in addition to medications would be exercise and appropriate diet.
Host: So blood sugar control, exercise, and diet. Lastly Dr. Jex, is there anything we should know about diabetic foot ulcerations and infections?
Dr. Jex: Only that it’s a very significant problem and any indication that, that’s occurring then they should see a professional right away.
Host: Well said and thanks Dr. Jex. To learn more and to get hooked up with one of our providers, visit dignityhealth.org/bakersfield/woundcare and if you liked what you’ve heard, please share it on your social channels and be sure to check out our full podcast library for topics of interest to you. This is Hello Healthy, a Dignity Health podcast. I’m Bill Klaproth, thanks for listening.