Diabetic Foot Ulcer Review

Hi, this is Dr. Donald Pelto, and I’m going to go over this week’s review of the current diabetic articles that we find on the internet.  So this first one here is from April 14th.  It’s “Foot wounds are a big threat to diabetics.” This is a study of people that had diabetes and they have foot wounds, and they’re talking about some new research.  And so what they said, they were trying to treat minor sores and to protect their feet.  So, people with diabetes often lose their feeling in their feet; that’s called neuropathy that we have talked about before.  This sensation can make one more prone to getting foot injury, which we all know about.  So this new analysis focused on 171 participants who reported having a foot ulcer of least 18 months and for a period of 18 months each person was checked for new ulcers.  During one week, sensors in their shoes reported how often participants wore their shoes and how many steps they took.  During the study, 71 people developed ulcers on the soles of the feet and 41 of them as a result of some type of trauma or injury, so really what this shows us is that the patients who wore the customized shoes on their feet had a 57 percent lower risk of developing new ulcers, so this is very important.  If you have diabetes it’s important for you to have diabetic insoles and diabetic shoes.  Now I usually recommend waiting until after the ulcer is healed before you get into the diabetic shoes, but once the ulcer is healed to help prevent problems, getting custom diabetic insoles and special diabetic shoes can be very helpful.  Here’s another video here about “Diabetic foot ulcers are deservingly feared.”  This is actually a question that was presented to Dr. Roach. “My father is an 84-year-diabetic.  He has a wound on his foot on the inner side for about five months.  He’s been treated by a podiatrist who debrides the wound every week.  He prescribed antibiotic when it looked infected.  A visiting nurse and my mother have been changing the dressings.  This week the podiatrist could see the bone, or osteomyelitis, and recommended hyperbaric treatment.  Could you tell me your opinion?” So, the answer here, which this doctor talks about, who isn’t a podiatrist, is actually an answer about hyperbaric ulcer treatment, and he says here basically that you want to prevent ulcers from developing, which is correct, and in extreme cases you do use hyperbaric treatment.  That’s actually one of the only reasons and only ways to get osteomyelitis or bone infection.  Usually what I say if someone has a bone infection or osteomyelitis, it can be removed surgically, removing the bone, or you can take six to eight weeks of IV antibiotics, or you can certainly try hyperbaric oxygen treatment.  Okay, this next article, “Stepping out for spring?  People with diabetes should check their feet first.”  So this is something that was, I believe, sponsored by the American Podiatric Medical Association, so the importance that as people are getting out and doing walking in the summertime, they should be checking their feet daily, and this is really of the utmost importance; not only checking your feet but also looking inside of your shoes to make sure that there’s nothing there.  So the first thing is to get a green light from your health care provider to make sure that everything is okay, be mindful of footwear, especially if something is too small or you don’t know it’s too small because you have neuropathy, and wear socks and well-fitting shoes.  If you have diabetes, you should probably wear a diabetic shoe that can be provided for you.  If you do notice a problem, it may be a foot ulcer.  So usually ulcers start as blisters and then develop into a sore.  It can be on the sides of your foot, on the bottom of your foot, it can just be seen as a blister, and if this blister isn’t treated it can get worse. Get your ulcers treated.  Really, you don’t want to wait.  You want to get these treated as quickly as quick as possible.  Let’s explain there’s one type of treatment here that can be used, but there are many different types of treatments and then let it heal.  Really, stay off your foot until things get better.