The most frequent complications of a person with diabetes are: ulcers, infections, and osteo-articular deformities clinically known as “Charcot’s foot”; the combination of these complications is called diabetic foot. Although these complications cannot always be prevented, it is still possible to drastically reduce their incidence and severity by implementing prevention with a podiatric treatment protocol. The key to amputation prevention is early detection and screening of the feet of patients at risk, at least once a year.

The role of the podiatrist.

The podiatrist through his or her training is able to prevent and treat diabetic foot complications.

Early signs.

For the diabetic who has not yet developed foot complications, there are early signs that should be recognized and brought to the attention of the family physician or podiatrist. They are:

• Chromatic changes (color changes) of the skin;
• Increased skin temperature;
• Swelling in the foot or ankle;
• Leg pain, both resting and walking;
• Frequent open wounds, with or without secretion, slow to heal;
• fungal nails (fungus) and onychocryptosis (ingrown nails);
• Hyperkeratosis (corns and calluses) with blood effusion;
• Epidermal crack (fissures), especially around the heel;

Ulceration is of common occurrence in the diabetic foot. Inadequate shoes or something much more trivial such as a sock seam, which are not immediately felt as bothersome by the diabetic due to a reduced level of sensitivity, can cause skin ulceration. Such ulcers, if left untreated, can quickly become infected and lead to serious consequences.