Medically reviewed by Dr. Tom Biernacki, DPM · Board-Certified Podiatric Surgeon · Last reviewed: April 2026 · Editorial Policy
The most important clinical decision with Diabetic Foot Ulcer Treatment Michigan 3 isn’t which treatment to start with — it’s identifying the correct subtype. That changes everything. Call (810) 206-1402.
Quick Answer
Diabetic Foot Ulcer Treatment in Michigan Wound Care & relates to diabetic foot care — typically caused by reduced circulation + neuropathy. Most patients improve in ongoing daily inspection with conservative care. Same-week appointments in Howell + Bloomfield Hills: (810) 206-1402.
Quick Answer
Diabetic peripheral neuropathy is nerve damage from prolonged hyperglycaemia, causing burning, tingling, numbness, or loss of protective sensation in the feet. It will not reverse without addressing glucose control. Daily foot checks, proper footwear, and annual monofilament testing prevent ulceration.
Watch: Dr. Tom Biernacki, DPM
Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.
▶ Watch
👟 Dr. Tom Also Recommends
Podiatrist Recommended Shoes 2026: Dr. Tom’s Top Picks for Every Condition
The right footwear can make or break your recovery. Dr. Tom’s complete guide to the best shoes for plantar fasciitis, flat feet, neuropathy, bunions & more — with clinical picks for every foot type.
See Dr. Tom’s Top Shoe Picks →Diabetic foot ulcers are open wounds on the feet that develop due to a combination of peripheral neuropathy (loss of protective sensation), peripheral arterial disease (reduced blood flow), and repetitive mechanical pressure — the triad that makes diabetes the leading cause of non-traumatic lower extremity amputation in the United States. At Balance Foot & Ankle in Southeast Michigan, Dr. Tom Biernacki provides comprehensive diabetic foot ulcer management focused on healing wounds, preventing infection, and reducing amputation risk for patients throughout the region.
Why Diabetic Foot Ulcers Are Serious
The combination of sensory neuropathy (inability to feel pain), motor neuropathy (intrinsic muscle weakness causing toe deformities and abnormal pressure distribution), and autonomic neuropathy (dry, fissured skin that breaks down more easily) creates conditions where small injuries — a blister from a shoe, a crack in dry skin, or pressure over a bony prominence — progress to open wounds without the patient noticing. Once open, reduced blood supply impairs wound healing and immune response. Early detection and expert wound management significantly reduce the risk of infection, osteomyelitis (bone infection), and amputation.
Wound Classification and Assessment
Dr. Biernacki evaluates diabetic foot ulcers using the Wagner Grading System and the University of Texas Wound Classification, which assess wound depth, presence of infection, and degree of ischemia. Vascular assessment (ankle-brachial index, toe pressures, or referral for vascular imaging) is critical for determining whether adequate blood flow exists to support healing. Probe-to-bone testing and X-rays assess for osteomyelitis. MRI is the gold standard for diagnosing bone infection when X-rays are inconclusive. This systematic assessment guides treatment decisions and establishes realistic healing expectations.
Treatment Approach
The foundation of diabetic foot ulcer treatment is offloading — removing the mechanical pressure that created and perpetuates the wound. Total contact casting (TCC) is the gold standard for plantar forefoot and midfoot ulcers; it distributes weight across the entire plantar surface and prevents patients from inadvertently loading the wound. Removable cast walkers (RCW) are an alternative when TCC is impractical, though patient adherence is lower. Sharp debridement of non-viable tissue and callus at each visit is essential — necrotic tissue harbors bacteria and prevents wound edge migration. Wound dressings are selected based on wound characteristics: moisture-retentive dressings for clean granulating wounds, antimicrobial dressings when surface bacterial burden is elevated, and negative pressure wound therapy (wound VAC) for larger wounds or post-operative defects. Antibiotic therapy is reserved for clinically infected wounds — not all diabetic ulcers are infected, and overuse of antibiotics promotes resistance. When vascular disease is limiting healing, vascular surgery referral for revascularization dramatically improves wound closure rates.
Advanced Wound Therapies
For wounds that fail to progress with standard care, advanced therapies may accelerate healing. Platelet-rich plasma (PRP) injections deliver concentrated growth factors directly to the wound bed. Bioengineered skin substitutes (dermal matrices, amnion-based products) provide a scaffold for new tissue growth. Hyperbaric oxygen therapy (HBOT) — in which the patient breathes 100% oxygen under pressure — increases oxygen delivery to ischemic wound tissue and is covered by Medicare for diabetic foot ulcers that have not responded to 30 days of standard care in patients with adequate vascular supply. Dr. Biernacki coordinates these advanced therapies as part of a thorough wound care plan.
More Podiatrist-Recommended Diabetic Essentials
Diabetic-Approved Walking Shoe
Orthofeet Sprint — seamless, extra-depth, designed for neuropathic feet.
Seamless Diabetic Sock
OS1st FS4 — non-binding, moisture-wicking, protects fragile diabetic skin.
Recovery Slide for Indoor Wear
HOKA Ora 3 — protects diabetic feet from barefoot injury at home.
As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. Product recommendations are based on clinical experience; prices and availability shown above update live from Amazon.
When to See a Podiatrist
One unnoticed blister on a neuropathic foot can become a limb-threatening ulcer in under 14 days. Medicare covers diabetic shoes (A5500) and comprehensive foot exams annually for most diabetic patients with neuropathy or circulation concerns. Balance Foot & Ankle runs a dedicated diabetic limb-preservation program — vascular screening, offloading, ulcer care, and shoe fitting — all in one visit. Schedule your annual diabetic foot exam today.
Call Balance Foot & Ankle: (810) 206-1402 · Book online · Offices in Howell & Bloomfield Hills
Frequently Asked Questions
How do I know if my diabetic foot wound is infected?
Signs of infected diabetic foot ulcer include: increasing redness (erythema) spreading beyond the wound edge, warmth, swelling, purulent (pus) drainage, an odor, worsening pain (though neuropathy may mask pain), and systemic signs like fever or elevated blood sugar. Any of these signs warrants urgent podiatry evaluation. Infected diabetic foot wounds can progress rapidly to osteomyelitis and may require hospitalization and IV antibiotics.
How long does it take for a diabetic foot ulcer to heal?
Healing time depends on wound size, depth, blood supply, blood sugar control, and adherence to offloading. Simple shallow neuropathic ulcers on the plantar forefoot with good blood supply typically heal in 4–8 weeks with proper offloading and wound care. Deeper wounds, those complicated by infection, or those with poor vascular supply may take months. Wounds that are not progressing at 4 weeks should be escalated to advanced wound therapies.
Does Medicare cover diabetic wound care visits?
Yes. Medicare covers medically necessary wound care visits for diabetic foot ulcers, including debridement, wound assessment, and dressing changes. Medicare also covers therapeutic diabetic footwear (one pair of shoes and inserts per calendar year) for patients with diabetes who meet clinical criteria — which helps prevent new ulcer formation. Our office assists with all Medicare wound care documentation requirements.
A diabetic foot wound is a medical emergency that requires specialist care. Contact Balance Foot & Ankle for urgent wound care evaluation with Dr. Biernacki in Southeast Michigan.
Dr. Tom’s Recommended Products for Diabetic Foot Care
📍 Located in Michigan?
Our board-certified podiatrists treat this condition at two convenient locations. Same-day appointments often available.
These are products I personally use and recommend to my patients at Balance Foot & Ankle.
- Dr. Comfort Men’s Paradise Diabetic Shoe — Medicare-covered diabetic shoe with seamless interior — eliminates pressure points that cause diabetic ulcers
- Foundation Wellness DASS Diabetic Socks (Levanta) — non-binding, seamless toe, moisture-wicking diabetic socks protecting neuropathic feet
- Derma Sciences Bordered Gauze Dressings — Non-adherent wound dressing ideal for diabetic foot wound management between podiatry visits
📧 Get Dr. Tom’s Free Lab Test Guide
Discover the 5 lab tests every person over 35 should ask their doctor about — explained in plain English by a board-certified physician.
Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. We only recommend products we trust for our own patients.
Join 950,000+ Learning About Foot Health
Dr. Tom shares honest medical advice, supplement reviews, and treatment guides you won’t find anywhere else.
Subscribe on YouTube →Blister-Prevention Socks and Products
- Darn Tough Merino Wool Socks — Lifetime Guarantee
- Balega Hidden Comfort — Ultra-Padded Running Socks
- Body Glide Anti-Blister Balm — Friction Prevention
Amazon affiliate links — we may earn a small commission at no extra cost to you.
Medically Reviewed by: Dr. Tom Biernacki, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists
Insurance Accepted
BCBS · Medicare · Aetna · Cigna · United Healthcare · HAP · Priority Health · Humana · View All →
Howell Office
4330 E Grand River Ave
Howell, MI 48843
Get Directions →
Bloomfield Hills Office
43494 Woodward Ave, #208
Bloomfield Hills, MI 48302
Get Directions →
Your Board-Certified Podiatrists
Ready to Get Back on Your Feet?
Same-week appointments available at both locations.
Book Your AppointmentDifferential Diagnosis: What Else Could It Be?
Several conditions share symptoms with Diabetic Neuropathy and are commonly misdiagnosed in the first office visit. Considering these alternatives is part of every Balance Foot & Ankle exam:
- Tarsal tunnel syndrome. Burning radiating into the arch with positive Tinel’s at the medial ankle.
- Peripheral artery disease. Pain with walking that resolves with rest, weak pulses, hair loss on toes.
- Lumbar radiculopathy. Symptoms following a dermatome, often with back pain — MRI of spine, not foot.
If your symptoms don’t fit the textbook pattern, ask your podiatrist which differentials they ruled out — that conversation often shortcuts months of trial-and-error treatment.
In Our Clinic
Diabetic neuropathy patients in our clinic often don’t realize they have it until we put a 10-gram Semmes-Weinstein monofilament to the plantar foot and they can’t feel it. Many arrive for an unrelated concern — an ingrown toenail, a callus — and we catch the neuropathy on screening. The conversation then shifts: we need to discuss daily foot inspections, appropriate footwear, the urgency of any blister or open area, and the timing of vascular referral if pulses are diminished. Comprehensive diabetic foot exams are covered by Medicare annually. If you have diabetes, we want to see you once a year even if nothing hurts.
Most Common Mistake We See
The most common mistake we see is: Stopping B-vitamin supplementation as soon as symptoms improve. Fix: maintain supplementation for 6-18 months alongside strict glucose control.
Warning Signs That Need Same-Day Care
Seek immediate evaluation at Balance Foot & Ankle if you experience any of the following:
- Sudden loss of sensation on one side
- Wound on the foot not felt by the patient
- One-sided symptoms (rule out compression)
- Back pain plus leg symptoms (possible radiculopathy)
Call (810) 206-1402 — same-day and next-day appointments at our Howell and Bloomfield Hills offices.
In-Office Treatment at Balance Foot & Ankle
When conservative care isn’t enough, Dr. Tom Biernacki and the team at Balance Foot & Ankle offer advanced, same-day options — including Diabetic Foot Care Michigan at our Howell and Bloomfield Hills clinics.
Same-day appointments available. Call (810) 206-1402 or book online.
Pros & Cons of Conservative Care for diabetic foot care
Advantages
- ✓ Daily inspection prevents amputation
- ✓ Most insurance covers DME
- ✓ Custom orthotics help
Considerations
- ✗ Daily commitment required
- ✗ Slow wound healing
- ✗ Charcot risk if neuropathy
Dr. Tom’s Recommended Products for diabetic foot care
Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. We only recommend products we use with patients.
Drew Moonwalker Diabetic Shoe Dr. Tom’s Pick
Best for: Medicare-covered diabetic footwear
Diabetic Compression Socks Dr. Tom’s Pick
Best for: Daily protection + circulation
Ready to Get Back on Your Feet?
Same-day appointments in Howell + Bloomfield Hills. Most insurance accepted. Dr. Tom Biernacki, DPM & team.
Book Today — Same-Day Appointments Available
Call Now: (810) 206-1402
About Your Care Team at Balance Foot & Ankle
Dr. Tom Biernacki, DPM · Board-Certified Foot & Ankle Surgeon. Specializes in conservative-first care, minimally invasive bunion surgery, and complex reconstruction.
Dr. Carl Jay, DPM · Accepting new patients. Specializes in sports medicine, athletic injuries, and routine podiatric care.
Dr. Daria Gutkin, DPM, AACFAS · Accepting new patients. Specializes in surgical reconstruction and pediatric podiatry.
Locations: 4330 E Grand River Ave, Howell, MI 48843 · 43494 Woodward Ave Suite 208, Bloomfield Hills, MI 48302
Hours: Mon–Fri 8:00 AM – 5:00 PM · (810) 206-1402
Dr. Tom’s Top 3 — The Premium Foot Pain Stack (2026)
If you only buy three things for foot pain, get these. PowerStep + CURREX orthotics correct the underlying foot mechanics, and Dr. Hoy’s pain gel delivers fast topical relief. This is the exact stack Dr. Tom Biernacki, DPM gives his Michigan podiatry patients on visit one — over 10,000 patients have used this exact combination.
Dr. Tom Biernacki, DPM is a board-certified podiatrist + Amazon Associate. Picks shown are products he prescribes to patients at Balance Foot & Ankle Specialists. We earn a commission on qualifying purchases at no extra cost to you. All products independently tested + reviewed for 30+ days minimum. Last verified: April 28, 2026.
PowerStep Pinnacle MaxxDr. Tom’s #1 Brand
Dr. Tom’s most-prescribed OTC orthotic. Lateral wedge corrects overpronation that causes 90% of foot pain. Deep heel cradle stabilizes the ankle. Built by podiatrists, used by patients worldwide.
- Lateral wedge corrects pronation
- Deep heel cradle stabilizes ankle
- Dual-density EVA — comfort + support
- Trim-to-fit any shoe
- Used by 10,000+ podiatrists
- Trim-to-size required
- 5-7 day break-in for some
CURREX RunProDr. Tom’s #1 Brand
3 arch heights for custom fit (Low/Med/High). Carbon-reinforced heel + dynamic forefoot — the closest OTC orthotic to a $500 custom orthotic. Engineered in Germany.
- 3 arch heights for custom fit
- Carbon-reinforced heel cup
- Dynamic forefoot zone
- Premium German engineering
- Sport-specific support
- Pricier than PowerStep
- 7-10 day break-in
Dr. Hoy’s Natural Pain Relief GelDr. Tom’s #1 Brand
Menthol-based natural pain relief — Dr. Tom’s #1 brand for fast relief without greasy residue. Safe for diabetics + daily use. Cleaner formula than Voltaren or Biofreeze.
- Menthol-based natural formula
- No greasy residue
- Safe for diabetics
- Fast cooling relief — 5-10 minutes
- Cleaner ingredient list than Biofreeze
- Pricier than Biofreeze
- Strong menthol scent at first
In-Office Treatment at Balance Foot & Ankle
If home treatment isn’t providing relief for your diabetic foot conditions, our podiatry team at Balance Foot & Ankle can help with same-day evaluations and advanced in-office care.
Same-day appointments available. (810) 206-1402
Doctor Hoy’s Natural Pain Relief Gel
Natural topical pain relief I use in our clinic. Arnica + camphor formula — apply directly to the area 3–4x daily. ($20–25)
Shop Doctor Hoy’s →Frequently Asked Questions
How long does treatment take to work?
Most patients see improvement in 4-8 weeks with consistent conservative care. Persistent symptoms after 8 weeks need imaging and escalation.
When is surgery needed?
Surgery is reserved for cases that fail 3-6 months of conservative care, structural deformities, or fractures requiring stabilization.
Is this covered by insurance?
Most diagnostic visits and conservative treatments are covered by Medicare and major insurers. Custom orthotics often require diabetic or post-surgical justification.
Our podiatrists treat the underlying cause, not just the symptom. Same-week appointments at our Howell and Bloomfield Hills, Michigan offices.
Ready for Expert Care?
Same-day appointments in Howell & Bloomfield Hills, MI.
4.9★ | 1,123 Reviews | 3,000+ Surgeries
Or call: (810) 206-1402
Dr. Tom Biernacki, DPM is a board-certified foot & ankle surgeon (ABFAS & ABPM) at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has made him one of the most-followed foot & ankle educators on YouTube.