• According to the American Diabetes Association, about 15.7 million people (5.9 percent of the United States population) have diabetes. Nervous system damage (also called neuropathy) affects about 60 to 70 percent of people with diabetes and is a major complication that may cause diabetics to lose feeling in their feet or hands.
  
  
• Foot problems are a big risk in diabetics. Diabetics must constantly monitor their feet or face severe consequences, including amputation. 

• With a diabetic foot, a wound as small as a blister from wearing a shoe that's too tight can cause a lot of damage. Diabetes decreases blood flow, so injuries are slow to heal. When your wound is not healing, it's at risk for infection. As a diabetic, your infections can spread quickly. When your wound is not healing, it's at risk for infection. If you have diabetes, you should inspect your feet every day. Look for puncture woulds, bruises, pressure areas, redness, warmth, blisters, ulcers, scratches, cuts and nail problems. Get someone to help you, or use a mirror.

• Always keep your feet warm
• Don't get your feet wet in snow or rain
• Don't put your feet on radiators or in front of the fireplace
• Don't smoke or sit cross-legged. Both decrease blood supply to your feet.
• Don't soak your feet.
• Don't use antiseptic solutions, drugstore medications, heating pads or sharp instruments on your feet.
• Trim your toenails straight across. Avoid cutting the corners. Use a nail file or emory board. If you find an ingrown toenail, contact our office.
• Use quality lotion to keep the skin of your feet soft and moist, but don't put any lotion between your toes.
• Wash your feet everyday with mild soap and warm water
• Wear loose socks to bed
• Wear warm socks and shoes in winter
• When drying your feet, pat each foot with a towel and be careful between your toes.
• Buy comfortable shoes without a "breaking in" period. The shoe should fit accurately at the time that you purchase it. Check how your shoe fits in width, length, bottom of heel and sole.
• Avoid pointed-toe styles and very high heels. Try to get shoes made with leather upper material and deep toe boxes. Wear new shoes for only two hours or less at a time. Don't wear the same pair everyday. Inspect the inside of each shoe before putting it on. Don't lace your shoes too tightly or loosely.
• Choose socks and stockings carefully. Wear clean, dry socks every day. Avoid socks with holes or wrinkles. Thin cotton socks are more absorbent for summer wear. Square-toe socks will not squeeze your toes. Avoid stockings with elastic tops.

• Because diabetes is a systemic disease affecting many different parts of the body, ideal case management requires a team approach. The podiatric physician, as an integral part of the treatment team, has documented success in the prevention of amputation, one of the most serious conditions that they treat. The key to amputation prevention in diabetic patients is early recognition and regular foot screenings, at least annually, from a podiatric physician like Dr. April.

• In addition to these check-ups, there are warning signs that you should be aware of so that they may be identified and called to the attention of the family physician or podiatrist. They include:

*Skin color changes

*Increase in skin temperature

*Swelling of the foot or ankle

*Pain in legs

*Open sores on the feet that are slow to heal

*Ingrown and fungal toenails

*Bleeding corns and calluses

*Dry cracks in the skin, especially around the heel

Wound Healing

• Ulceration is a common occurrence with the diabetic foot, and should be carefully treated and monitored by a podiatrist to avoid amputations. Poorly fitted shoes, or something as trivial as a stocking seam, can create a wound that may not be felt by someone whose level of skin sensation is diminished. Left unattended, such ulcers can quickly become infected and lead to more serious consequences.
  
  
• Dr. Carmen April is skilled in treating and preventing these wounds and can be an important factor in keeping your feet healthy and strong. New to the science of wound healing are remarkable products that have the appearance and handling characteristics of human skin. These living, skin-like products are applied to wounds that are properly prepared by Dr. April. Clinical trials indicate that when applied to wounds, even those that were hard to heal, such products achieve impressive success rates.