Uncontrolled and patients with long standing diabetes are at greater risk of developing sores or diabetic ulcers. These patients who have corns or calluses are at greater risk of developing these open wounds of the skin even without having pain. Diabetics are at risk of developing circulation and neurological complications. These complications can lead to open wounds and amputations. Patients with uncomplicated diabetes should have their feet examined at least once a year to access their circulation and neurological status. All patients who have circulation issues such as pad (peripheral artery disease) or neuropathy need to be seen much more frequently. Patients who have PAD (absent pulses in their feet) or LOPS…Loss of Protective Sensation (no feeling in their feet) qualify under Medicare and most other insurances every 61 days for evaluation and treatment of toenails, corns and calluses. Initial exams to determine if you have either of these qualifying conditions are covered by medicare and most insurances.
For most of our patients, our care is geared to prevention vs closing of wounds of the foot and ankle. Preventive care involves keeping pressure lesions like corns and calluses from developing into blisters and open wounds. This is accomplished with periodic trimming, protective shielding, off the shelf and custom shoe inserts and shoes. Some patients may require surgical care to reduce mal alignment issues like bunions, hammertoes and spurs. We also work closely with other medical specialist such as internist, vascular specialists and infectious disease in order to achieve the best outcome for our patients.
Open wounds in diabetic with complications is a serious challenge and can result in a protracted healing time. Fortunately, we have many new options to help win this war: anti-infective medications, revascularization, wound growth factors, and skin substitutes to name just a few. Keys to best outcomes: don’t let an ulcer get started. Be proactive in getting care before disaster strikes, and when it does strike, do not delay in getting attention immediately.