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Diabetic Nerve Damage May Lead to Ulcers, Infection, Amputation

BOARDMAN, Ohio (Nov. 15, 2019) - If you have diabetes, your feet are at risk for serious complications, some of which can lead to the loss of function in a limb or even amputation.

Podiatric physicians at NOMS Ankle & Foot Care Centers are warning Mahoning Valley individuals with diabetes to secure proper foot care and take preventative measures to avoid nerve damage, diabetic ulcers or wounds and amputation.

According to the American Diabetes Association, more than 70 percent of people with diabetes suffer from diabetic peripheral neuropathy, or nerve damage in the limbs, that can lead to the loss of feeling in the feet, preventing them from functioning properly.

"Individuals who can't feel their feet, also can't feel when they have an injury, callus or sore," said Dr. Lawrence DiDomenico, who treats patients at NOMS Ankle & Foot Care Centers in Boardman, Youngstown and East Liverpool. "Often times, when left untreated, these conditions worsen and may turn into open wounds, leading to infection."

Although nerve damage is not often reversible, those with diabetes who understand the symptoms and complications can take preventative measures to limit worsening conditions, such as ulcers.

A diabetic ulcer is an open sore or wound that most commonly occurs on the bottom of the foot. Ulcers surface in about 15 percent of patients with diabetes. Of those who develop a foot ulcer, 6 percent will be hospitalized due to infection or other ulcer-related complication.

"We advise patients with diabetes or those at risk to do daily foot exams and schedule checkups by a podiatrist at least twice a year to prevent ulcers, corns and calluses, or more severe conditions," said Dr. DiDomenico.

"Pain, numbness or tingling in your feet is not normal," he added. "It's important for those with diabetes and neuropathy to be aware of the signs and symptoms of ulcers and see a podiatrist immediately if they see one forming.

"Timely treatment will reduce the risk of infection and amputation," says Dr. DiDomenico. "Treatment can also improve function and quality of life and reduce the likelihood of expensive medical care in the future."

A comprehensive foot care treatment plan, including risk assessment, foot care education, preventative therapy, treatment of foot problems, as well as referral to specialists, can reduce amputation rates by as much as 85 percent, says the Centers for Diseases Control.

According to the American Podiatric Medical Association, more than 65,000 lower limbs are amputated annually due to complications from diabetes. And every thirty seconds, a limb is lost to diabetes worldwide.

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National Diabetes Month: Questions & Answers

What is a diabetic ulcer?
Diabetic ulcerations are often one of the first signs of complications from diabetes in the lower leg. These ulcers (or sores) can stem from a small wound or cut on the foot that is slow to heal. If left untreated, ulcers can grow larger and become harder to successfully treat. Often, ulcers can become infected, and can lead to partial or full amputation of the foot or lower leg. If discovered early and treated by a podiatrist, ulcers may not lead to amputation.

Won't I know it when I have a cut or wound on one or both of my feet?
Not always. Those with diabetes can often experience what is called "diabetic neuropathy" - a numbness or lack of sensation of the lower legs and feet. Neuropathy can often make the beginning stages of diabetic ulcers difficult to feel. This is why it is important to have a physician check both feet at routine exams, and to have yourself or a family member check your feet daily for signs and symptoms.

What are the warning signs?
As neuropathy makes it difficult to feel sensation in the limbs, waiting for pain in the feet to detect ulcers is usually not an option for those with diabetes. Chief warning signs to look for include irritation, redness, cracked and dry skin (especially around the heels), and drainage on socks. If you experience any of these symptoms, you should be evaluated by a medical professional.

Where do diabetic ulcers most often occur?
Typically, diabetic foot ulcers occur at points of increased pressure, such as the ball of the foot or the bottom of the big toe. However, ulcers can appear anywhere on the foot or ankle.

I have heard of the term "diabetic hotspot." What is that?
Diabetic hotspots are specific areas of the feet of individuals with diabetes. These areas have higher skin temperatures compared to the rest of the feet, usually due to increased pressure. These temperature differences have been shown to help healthcare providers predict where a diabetic ulcer will present before it actually does.

If I discover what I think is a diabetic ulcer, is it too late to save my lower limb?
No. If discovered early and treated by a podiatrist or primary care physician, many ulcers can be successfully healed without resorting to amputation. Additionally, several new technologies used today may increase the healing rate of diabetic wounds.

Can a podiatrist help treat and manage diabetic ulcers?
Yes. Podiatrists are an integral part of the diabetes management team and are experts in wound care.

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For more information, contact:

Michael Vallas, Practice Administrator
NOMS Ankle & Foot Care Centers 
(330) 758-6226 ext. 207

Kelli Hulea
Pecchia Communications
(330) 727-0949

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