November is Diabetes Awareness Month, and for many people feet are the last thing they think of when they hear the word diabetes.
Diabetic patients are at a higher risk of developing foot problems than those without diabetes, due to nerve damage and poor circulation associated with the disease. 60-70% of diabetics experience damage to nerves that diminish the pain sensation, this is called neuropathy. The idea of less pain sounds great, but without normal pain sensation we become less aware when we injure ourselves. Injuries such as scratches, blisters or sores can lead to an infection and if gone unnoticed become very serious.
Diabetics also have a lower immune system as well as decreases blood flow, thus significantly slowing the healing process. Therefore an infection in a diabetic patient is much more serious than that of a non-diabetic because of the body’s ability to fight off the infection is weakened. Due to a lower immune system and decreased blood flow, this once simple skin wound can spread to underlying muscle, and even into bone. Infection in bone is called osteomyelitis and is a very serious condition that can quickly lead to loss of the toe, foot, or possibly the limb.
Due to the serious consequences that can come from even the smallest scratch in a patient with diabetes, it is recommended diabetic patients be seen by a podiatrist at least once a year. This significantly decreases the chances of small cuts or nicks going unnoticed and progressing into more serious situations. This can and will save you unnecessary pain as well as money. Even a minor injury to a diabetic patient is an emergency, and it is highly recommended to visit your podiatrist immediately if you experience any injury to your foot.
List of recommendations for keeping diabetic feet healthy
- Wash and fully dry feet daily making sure to inspect them for any injuries or nail problems
- Be sure to inspect between the toes
- Wear supportive shoes that fully cover the toes as well as the heel, even when around the house
- Do not self-treat your calluses
- Elevate your feel while sitting to increase circulation
The key to keeping a diabetic foot healthy is prevention and early detection. If you or someone you know is diabetic and does not have a podiatrist please contact First Coast Foot & Ankle Clinic.
Between the changing of seasons bringing cooler temperatures, and events such as the 2012 First Coast Heart Walk, and Northeast Florida Beer Cup approaching, September is shaping up to be an exciting month in Jacksonville.
September is also P.A.D awareness month. P.A.D stands for Peripheral Arterial Disease and currently affects around 8 million Americans. People with PAD are at significantly increased risk for stroke and heart attack. If caught early P.A.D is preventable and can be easily treated.
P.A.D occurs when arteries in the legs become clogged or blocked by fat deposits and cholesterol that stick to and accumulate on the walls of the artery. The more narrow and hard the artery is, the harder it is for blood to pass through, leading to decreased blood flow to the legs and feet that can result in a number of symptoms.
These symptoms include:
- Painful cramping in the legs while walking
- Numbness and/or weakness of the lower extremity
Symptoms that occur later in the disease include:
- Pain or burning in the feet or toes while resting
- Coolness and color changes of the skin
- Loss of hair
- Wounds of the feet or toes that do not heal
Risk factors include:
- High cholesterol
- Sedentary lifestyle
- Age greater than 50
Here at First Coast Foot Clinic, we use the reliable, non-invasive Ankle-Brachial Index (ABI) to test for P.A.D. Blood pressures are taken on both the arm and the ankle, and are compared to each other. The ankle blood pressure should be about the same as the arm blood pressure, in which normal values are 0.95-1.2. If it is below this, a patient will be tested further for P.A.D.
Sometimes P.A.D can show no symptoms at all, so it is important to get tested if you are at risk. So while you are enjoying the Northeast Florida Beer Cup, be aware of what puts you at risk and remember you can always walk off those extra beer calories at the First Coast Heart Walk and keep your lifestyle active. September is going to be a great month here in Jacksonville, but try to stay aware of P.A.D and catch it early.
The APMA recently described the U.S. Hispanic population as being at the center of a “perfect storm” for diabetes diagnoses. Contributors of type 2 diabetes include:
- Poor diet
- Lack of exercise
Unfortunately Hispanics are at risk for all three, making them 66% more likely than non-Hispanic whites of becoming a diabetic. This news is especially important in Florida, where Hispanics are nearly one quarter of the population.
Regardless of one’s racial makeup, the good news is that knocking your socks offmay be the answer! The APMA campaign encourages those with diabetes to take the first step to avoid some of the most serious difficulties of diabetes: Get an annual foot exam from a podiatrist. By checking in with Dr. Vimal Reddy at least once a year, he will be able to examine your feet and watch for complications. Some of the complications that can be prevented include:
- Nerve damage (neuropathy)
- Foot Ulcers
If every at risk individual had an annual foot exam, it could save the U.S. an estimated $3.5 billion each year—and it could save your foot. There’s no better time than NOW to make an appointment with Dr. Reddy at the First Coast Foot & Ankle Clinic in Jacksonville, FL for your yearly diabetic foot evaluation.
A recent study in the Archives of General Psychiatry found that in the past decade the number of Americans taking antidepressants has doubled. Psychiatrists are not prescribing most of these antidepressants because the majority of Americans taking antidepressants are not being treated for depression. The drugs are not being used to treat a mental health problem so it’s unnecessary to call in the mental health specialists.
Using antidepressants to treat conditions other than depression might sound wrong, but some drugs have more than one use. The FDA must initially approve a new drug for a specific condition, for example, treating depression. If a new use for a drug is discovered, doctors are free to prescribe it for that use as long as they find it justifiable. After many studies and trials, the FDA might approve the drug for a new purpose beyond what it was originally invented for.
So how is this relevant to podiatry? According to Dr. Vimal Reddy, a variety of diseases—including diabetes—result in painful tingling sensations in the feet, peripheral neuropathy. It has been discovered that certain drugs used to treat depression also have the benefit of reducing these painful sensations. Under the care of a physician, these drugs are generally safe and can provide relief for those suffering from peripheral neuropathy. With the diabetic population growing, even in Jacksonville FL, more people will suffer from peripheral neuropathy and seek the relief these antidepressants may provide.
With diabetes on the rise, it is important more then ever for diabetics to manage their health by keeping their blood sugar (or bloodglucose) under control. To do this, patients need to check their blood glucose regularly. Here at the First Coast Foot and Ankle Clinic, we take the same position as the American Diabetes Association:
- Check your blood glucose daily
- Keep a log to monitor how it changes from day to day
By keeping a close watch over your blood glucose, you are doing something of vital importance for your over-all health, including your feet. Unfortunately, many people in Jacksonville, FL have trouble maintaining the daily regimen recommended due to:
- Checking your glucose can be painful: To minimize the pain, try to draw blood from different sites each day.
- Glucose test strips are not cheap: If you have difficulty paying for test strips, at the very least try to check your blood glucose three times a week.
People who do not control their blood glucose are at risk for losing sensation in their feet—a disease called peripheral neuropathy. Without the ability to sense pain, touch, or pressure in your feet, you won’t be able to know if you are doing something that is hurting your foot. At this point, foot care becomes extremely important because of the heightened possibility of injuries and infection.
Being diagnosed with diabetes can seem like a life-altering event, but does not mean you cannot continue living a healthy, active, life. Dr. Reddy can work with your primary care provider to help you manage your diabetes while still getting the most out of your life.
A recent study by Thomson Reuters found if diabetic patients visited a podiatrist just once before complications from a diabetic foot ulcer set in, it would result in $3.5 billion in savings for the US health-care system in one year. Podiatrists like Dr. Vimal Reddy are well trained in the diagnosis and treatment of diabetic foot ulcers. If caught early the disease process does not escalate like it otherwise would if the patient had not seen a podiatrist, equaling fewer health care dollars spent.
People with diabetes often lose feeling in their feet, known as neuropathy. As a result, an individual with diabetes is more at risk of injuring their feet without knowing so. For example: You decide to check out the Jacksonville Riverside Art Market on Saturday. Unfortunately, you have a rock in your shoe and walk all day without knowing the rock is rubbing the same spot over and over again. By the time you get home to kick off your shoes, you discover the rock and a fresh new wound. Unfortunately, people with diabetes heal wounds more slowly, causing the wound to become infected more easily. Sadly, many patients can lose their feet as a result. Podiatrists are at the forefront in preventing these disasters, and the physical, emotional and financial savings are substantial.
This is an EXTREMELY big deal and here’s why:
- As a nation, we are already in a cost-cutting mode
- Finding ways to trim health care expenditures is important, and podiatrists can help
- Jacksonville lies just outside the Diabetes Belt, and podiatrists like Dr. Reddy have an important role locally.
If you have diabetes, you have everything to gain from forming a good relationship with a podiatrist. So stop over to the First Coast Foot and Ankle Clinic near St. Luke’s Hospital, and learn how you can save both your feet and your money!
The Centers for Disease Control has released a new outline where diabetes is particularly prevalent in the United States. They have dubbed it…The Diabetes Belt. “The Belt” spans across the South, from Tennessee to West Virginia, Louisiana to Georgia, including parts of Northern Florida. Jacksonville lies just outside of the Diabetes Belt. While diabetes is clearly a severe problem in other parts of the country, Jacksonville has much room for improvement as well.
While the study does not distinguish between Type 1 (juvenile onset) and Type 2 (adult onset) diabetes, 90% of all diabetics are Type 2. Factors affecting this include:
- Lack of exercise
Different counties within the Diabetes Belt also have higher incidence of strokes. This association is not surprising, as diabetes is associated with cardiovascular disease. The same disease process which leads to strokes, also leads to diseases of the blood vessels in the foot. Unfortunately the diabetic foot has poor circulation, taking it longer for wounds to heal. This is where Dr. Vimal Reddy at the First Coast Foot and Ankle Clinic can help. As a podiatrist, Dr. Reddy is better equipped than doctors of other specialty to address problems that arise in the feet.
The Centers for Disease Control released new figures estimating the number of people with diabetes at nearly 26 million. This is an increase of 2.4 million from 2008. Furthermore, the number of Americans with pre-diabetes is up to 79 million. This is a shockingly high increase of 22 million from 2008. These distressing figures indicate that podiatrists such as, Dr. Vimal Reddy, will become increasingly more important in helping the growing number of people living with diabetes and pre-diabetes.
Those with diabetes gradually lose their ability to control their blood sugar. High blood sugar affects blood vessels. When the blood vessels become diseased, problems arise in the foot including loss of sensation and ulcers. Unfortunately, before blood sugar gets high enough to diagnose an individual with diabetes, high blood sugar can and will affect the body. This is why the increasing number of people with pre-diabetes is an important problem to deal with. Many of our patients at the First Coast Foot Clinic in Jacksonville, FL have these same problems, which Dr. Vimal Reddy can address.
Fortunately, we are becoming better at treating diabetes, and people with this disease are living longer and healthier lives. We are also getting better at diagnosing diabetes. Therefore people with this condition can find out sooner to be able to get the treatment they need. If you are at risk or think you may be at risk for diabetes, your podiatrist can advise you on the steps to take to prevent this disease. If you think you may have diabetes, set up an appointment with Dr. Reddy for a foot screening.