The Feet We Treat
Medical Pedicure + Therapeutic Skincare for:
- Individuals with Diabetes
- Individuals with Advanced Age
- Individuals with Peripheral Neuropathy
- Individuals with a Foot Deformity
- Individuals with Peripheral Arterial Disease
- Individuals with a History of Diabetic Foot Ulcer(s)
- Individuals with a History of Lower Extremity Amputation(s)
- Individuals with Chronic Kidney Disease, including End-Stage Renal Disease on Hemodialysis / Peritoneal Dialysis
- Individuals with Diabetic Retinopathy / Macular Degeneration
- Individuals with Cardiovascular Disease
- Individuals with a Visual Impairment
- Individuals with Decreased Mobility
- Individuals Dealing with Obesity
- Individuals with Osteoarthritis and HLA-B27 Syndromes
- Individuals Receiving Chemotherapeutics and/or Radiation Treatment
- Individuals with an Immunodeficiency
- Individuals who are Immunocompromised
The Diabetic Foot
A diabetic foot is a foot that exhibits any pathology that results directly from diabetes mellitus or any long-term (or “chronic”) complication of diabetes mellitus. Presence of several characteristic diabetic foot pathologies such as infection, diabetic foot ulcer and neuropathic osteoarthropathy is called diabetic foot syndrome.
Due to the peripheral nerve dysfunction associated with diabetes (diabetic neuropathy), patients have a reduced ability to feel pain. This means that minor injuries may remain undiscovered for a long while. People with diabetes are also at risk of developing a diabetic foot ulcer. Research estimates that the lifetime incidence of foot ulcers within the diabetic community is around 15% and may become as high as 25%.
In diabetes, peripheral nerve dysfunction can be combined with peripheral artery disease (PAD) causing poor blood circulation to the extremities (diabetic angiopathy). Around half of patients with a diabetic foot ulcer have co-existing PAD.
Where wounds take a long time to heal, infection may set in and lower limb amputation may be necessary. Foot infection is the most common cause of non-traumatic amputation in people with diabetes.
Diabetic neuropathy affects all peripheral nerves including sensory neurons, motor neurons, but rarely affects the autonomic nervous system. Therefore, diabetic neuropathy can affect all organs and systems, as all are innervated. There are several distinct syndromes based on the organ systems and members affected, but these are by no means exclusive. A patient can have sensorimotor and autonomic neuropathy or any other combination. Signs and symptoms vary depending on the nerve(s) affected and may include symptoms other than those listed. Symptoms usually develop gradually over years.
Symptoms may include the following:
- Trouble with balance
- Numbness and tingling of extremities
- Dysesthesia (abnormal sensation to a body part)
- Erectile dysfunction
- Urinary incontinence (loss of bladder control)
- Facial, mouth and eyelid drooping
- Vision changes
- Muscle weakness
- Difficulty swallowing
- Speech impairment
- Fasciculation (muscle contractions)
- Burning or electric pain
Peripheral Arterial Disease
Do you have good blood flow to the toe? Do you have pain in the foot and lower leg, pain when walking a certain distance, history of smoking, and/or pain while lying flat at night? Let our team utilize the latest technology to determine whether you have adequate blood flow going to the foot and toes!
Adequate blood flow to the foot and toe is crucial to support tissue requirements, and reduce the risk of a diabetic foot ulcer. Also, adequate return blood flow out of the foot and lower leg is crucial, reducing risk of a venous leg ulcer.
Do your feet hurt? Do you have calluses? Is there a bone that looks like it should not be there? Let our team establish your personal foot’s blueprint through examination, imaging, and gait analysis!
Areas of increased pressure to the foot because of a bony deformity lead to an increased risk of callus formation, tissue breakdown, and risk of developing a diabetic foot ulcer (wound).
Diabetic Foot Ulcers (DFUs)
Diabetic foot ulcer is a major complication of diabetes mellitus, and probably the major component of the diabetic foot.
Wound healing is an innate mechanism of action that works reliably most of the time. A key feature of wound healing is stepwise repair of lost extracellular matrix (ECM) that forms the largest component of the dermal skin layer. But in some cases, certain disorders or physiological insult disturbs the wound healing process. Diabetes mellitus is one such metabolic disorder that impedes the normal steps of the wound healing process. Many studies show a prolonged inflammatory phase in diabetic wounds, which causes a delay in the formation of mature granulation tissue and a parallel reduction in wound tensile strength.
Treatment of diabetic foot ulcers should include: blood sugar control, removal of dead tissue from the wound, wound dressings, and removing pressure from the wound through techniques such as total contact casting. Surgery in some cases may improve outcomes. Hyperbaric oxygen therapy may also help but is expensive.
It occurs in 15% of people with diabetes, and precedes 84% of all diabetes-related lower-leg amputations.