Dr. Mark H. Tompkins ● 4402 Vance Jackson, Suite #146 ● San Antonio, Texas 78230
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Diabetic Foot
by Mark H. Tompkins
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| Diabetic Foot Diabetics comprise a large number of patients seen in our practice everyday. Why do people with diabetes have foot problems? To begin with, a basic understanding of Diabetes Mellitus (DM) will help shed some light on the reasons.
Diabetes Mellitus (DM) is one of the most common metabolic (relating to
the chemical processes which occur within the body) diseases affecting
the human body. DM is a systemic (affects the entire body system)
condition where the percentage of glucose (the body's fuel source=sugar)
in the blood stream remains above normal levels (hyperglycemia). |
DM can either be present at birth (congenital-Type I) or acquired during one's lifetime (acquired-Type II). In patients with DM there is a reduction in the amount of insulin, or the insulin does not function properly. Insulin is normally produced within the pancreas and allows the glucose (sugar) we intake to be converted into usable energy for our bodies. This
increase in circulating glucose (or highly fluctuating levels) affects many parts
of the body; namely, the eyes, the kidneys, and the feet. In the eyes, patients
with DM develop what is called diabetic retinopathy. This degenerative process
slowly steals the vision of diabetic patients and can lead to total blindness.
In the kidneys, progressive destruction of the glomeruli slowly reduces the ability
of the kidneys to cleanse the body of its own toxins and many patients end-up
on dialysis and/or needing a kidney transplant. |
In the feet, long-standing DM affects almost all organ systems-the skin, the blood vessels, the nerves, and the bones. The skin of diabetics looses much of its elasticity, becomes dry and unhealthy, and allows the foot to become more prone to infections. The blood vessels become more prone to arteriosclerosis (hardening of the arteries) and over time, can lead to varying degrees of ischemia (tissue death due to poor circulation). The nerves become prone to a condition referred to as peripheral diabetic neuropathy. Symptoms range from mild numbness and/or tingling to severe burning pain, to complete anesthesia (no feeling at all). This leaves the foot vulnerable to unknown injuries, increased risk of infections, and many times amputation of parts of the foot and/or the entire leg. The bones are prone to osteoporosis (weakening, or thinning of the bones) due to diminished blood flow from arteriosclerosis and diminished nerve supply from neuropathy. As
you can see, DM is an extremely destructive condition/process. Not only when
it comes to patient's feet, but many different organ systems within the body.
Early diagnosis of Type II DM is the most important criteria to prevent and limit
the long-term problems associated with this disease. |
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the definitive diagnosis of DM has been established by a credentialed medical
professional, THE MOST IMPORTANT thing you can do to limit the progress of the
destructive processes to your feet is to manage your diabetes properly. You must
work closely with the medical doctor who is treating your diabetes. If you do
not have a doctor-get one immediately! Maintaining your appropriate diet, taking
your medication as prescribed, monitoring your blood sugar, and getting sufficient
exercise are paramount to preventing potential long-term podiatric problems. |
Dr. Tompkins sees his diabetic patients routinely depending on the level and severity of the patient's individual DM condition. My professional opinion is.the minimum number/level of routine podiatric evaluations in patients with DM should be three times a year (once every four months). This is irregardless of the fact that the patient may feel that he/she has 'no problems'. During
these visits, Dr. Tompkins will provide any evaluation and/or treatment necessary
to limit the possibility of developing these potential long-term complications.
One important point to note is. DO NOT attempt to treat any foot ailment on your
own. If you have any problems and/or questions before your next scheduled appointment,
call the office immediately to be seen earlier!! |
If you have been diagnosed with Type II DM, the following is a partial list of the things you should do to help prevent foot complications from occurring:
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In
closing, many of the long-term podiatric complications associated with DM can
(and are) prevented by simply educating yourself about the disease itself. Education
is the single most important issue facing health care professionals when dealing
with DM. An informed patient is a better patient! |
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Phone: (210) 341-2202 ● Dr. Mark H. Tompkins ● Park North Professional Building ● ● 4402 Vance Jackson, Suite #146 ● San Antonio, Texas 78230 ● |
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