Amanda Wilde (Host): Over time, diabetes can damage the nerves and blood vessels in the feet and that can be devastating, but patients may not recognize early signs. We'll talk about symptoms and treatments for diabetic feet with Dr. Eric Rindlisbacher, Podiatric Surgeon at Woodlawn Health. This is Woodlawn Health Doc Talk, a podcast from Woodlawn Health. I'm Amanda Wilde, Dr. Rindlisbacher, welcome back to the podcast.

Dr. Eric Rindlisbacher, DPM: Good to be here.

Host: Diabetic feet is something I had not heard from, but foot problems are common in people with diabetes. What are the signs and symptoms of diabetic feet?

Dr. Eric Rindlisbacher, DPM: So early on with diabetes, your signs and symptoms are going to be very mild. You probably won't even notice, much of a change. But you'll start to notice over time dryness in the legs and the feet. And then from there, you'll get numbness and tingling. And those are kind of those early signs that you probably have something happening with your diabetes.

Host: The problem is if you're already becoming numb, you may not realize that you already have lost some feeling. So what should those with diabetes do daily to care for their feet?

Dr. Eric Rindlisbacher, DPM: So the most important thing with diabetes, is not even something that I do, but it's controlling your blood sugars. And so making sure that you're seeing a physician regularly, checking on your blood sugars, getting those annual exams is vital, because controlling those blood sugars is going to stop any progression of that diabetes.

But if you've had diabetes or just diagnosed with diabetes, you should be checking your feet every day. You basically can't trust yourself anymore. You can't trust those feelings that you have had your entire life that you think you can feel your feet like you did when you were 15.

You have to visually inspect and use other senses to check to make sure nothing is going on. And what we see is that, if you don't check, you can run into problems. You can get sores, you can get wounds. And it's just because you don't feel what's going on in your feet.

Host: So you should still check your feet even if you don't feel any pain.

Dr. Eric Rindlisbacher, DPM: Absolutely. And that's key is the pain changes. And that's one of the important reasons to get in to see a podiatrist is for us to evaluate the progression of your symptoms. Because if you don't feel the same as you did before, I always tell my patients a story like this, you know, imagine I was walking down a trail with a rock in my shoe.

I wouldn't let that rock stay in my shoe very long before I sat down and kick that rock out. Someone with diabetes may not know that rock is there, and they may walk all day, they may walk two days with that rock in their shoe. And that amount of pressure, will break down the skin and cause a sore or a wound that, then we have to treat.

Host: Yeah, there are injuries and infections that can happen with this condition. So let's say you are checking daily, you don't notice anything amiss, but when should you see a doctor?

Dr. Eric Rindlisbacher, DPM: The recommendation, is when you have diabetes, you should have an initial evaluation by a podiatrist, to give you a clear check, check your symptoms, give you some treatments, things you can do to prevent any issues moving forward. And then from there, as long as your symptoms are mild, you know, a checkup once a year is probably enough.

However, a lot of times there's more complications that are going forward. So a lot of times I'll see patients about every three to four months even, if they have symptoms.

Host: So you get this baseline and then you can watch if there is a progression. And if there is a progression, what can podiatry do to address diabetic feet?

Dr. Eric Rindlisbacher, DPM: So a lot of times, you have to look at the foot. The whole body weight's coming on the bottom of a foot. And so what we spend a lot of our time doing is adjusting a shoe or an insert, so that, you, when you're walking, aren't putting so much pressure on one spot, causing breakdown, over time.

So, callus on a diabetic, we call that a pre ulcerative lesion. It's a big name for just saying your callus is on a diabetic foot are a much more serious thing than it is on someone who has normal sensation, without diabetes. And if they're not checked regularly, even as something as small as a callus can add enough pressure, that you can break down into an infection or, a wound. And so those regular checkups are very important.

Host: Well, Doctor, thank you so much for your expertise in this subject and for this important information on diabetic feet.

Dr. Eric Rindlisbacher, DPM: Thank you.  

Host: Dr. Eric Rindlisbacher is a podiatrist and podiatric surgeon with Woodlawn Health.

Amanda Wilde (Host): want to find out more information.

Visit Woodlawn Health's website@woodlawnhealth.org or call 5 7 4 2 2 3 9 3 9 3 to schedule an appointment. And thanks for listening to Woodlawn Health Doc Talk, a podcast by Woodlawn Hospital.