![Diabetic Foot Care 101 [Diabetic Foot Pain: Podiatrist Treatment] | Balance Foot & Ankle](https://www.michiganfootdoctors.com/uploads/2021/05/diabetic-foot-care-101-diabetic-foot-pain-podiatrist-treatment.avif)
Dr. Tom’s Top Foot Health Supplements
Affiliate disclosure: Amazon Associate. Always discuss supplements with your physician before starting.
Vitamin B12 Methylcobalamin
Neuropathy support · Nerve repair
PROS
Treatment at Balance Foot & Ankle: Diabetic Foot & Circulation Screening →
- Active B12 form
- Sublingual absorption
- Neuropathy adjunct
CONS
- Effects take 2-3 months
- Doesn’t replace medical care
Alpha Lipoic Acid 600mg
Diabetic neuropathy · Nerve antioxidant
PROS
- Peer-reviewed for neuropathy
- Both fat- and water-soluble
- Clinical doses available
CONS
- Possible blood sugar effect
- GI upset possible
Acetyl-L-Carnitine (ALCAR)
Diabetic neuropathy · Energy
PROS
- Crosses blood-brain barrier
- Studied for nerve repair
- Pairs with ALA
CONS
- Effects gradual (3+ months)
- Higher cost
Vitamin D3 5000 IU
Bone health · Stress fracture prevention
PROS
- Improves bone density
- Most patients deficient
- Affordable preventive
CONS
- Get blood test first
- Toxicity at very high doses
Dr. Tom’s Diabetic Foot Care Kit
Always under podiatric supervision for diabetic patients.
Dr. Tom’s Wound Care Kit
Medically reviewed by Dr. Tom Biernacki, DPM · Board-Certified Podiatric Surgeon · Last reviewed: April 2026 · Editorial Policy
Quick Answer
For Endocrinologists: Our Diabetic Foot Care Protocol at Bal 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 Twp: (810) 206-1402.
Medically reviewed by Dr. Tom Biernacki, DPM — Board-certified foot & ankle surgeon, 3,000+ surgeries performed. Updated April 2026 with current clinical evidence. This article reflects real practice experience from Balance Foot & Ankle Specialists in Howell and Bloomfield Hills, Michigan.
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. Thomas Biernacki, DPM — Board-Certified Podiatrist · Last updated April 6, 2026
For Endocrinologists: Our Diabetic Foot Care Protocol at Balance Foot & Ankle
Diabetic foot complications represent one of the most preventable yet devastating consequences of diabetes. Our protocol is designed to integrate seamlessly with your endocrinological management for comprehensive, coordinated patient care.
Our Diabetic Foot Exam Protocol
Every diabetic patient receives a comprehensive assessment covering four domains:
- Neurological: 10-gram Semmes-Weinstein monofilament testing at 10 plantar sites, 128Hz tuning fork for vibratory threshold, deep tendon reflexes
- Vascular: Pedal pulse assessment (dorsalis pedis, posterior tibial), capillary refill, skin temperature gradient, ABI if indicated
- Musculoskeletal: Gait analysis, range of motion assessment, deformity documentation (hammertoes, bunions, Charcot changes), pressure mapping
- Dermatological: Skin integrity assessment, ulceration screening, callus documentation, nail health evaluation
Risk Stratification & Visit Frequency
| Risk Category | Criteria | Visit Frequency |
|---|---|---|
| Low Risk | No neuropathy, no PVD, no deformity, no prior ulcer | Annually |
| Moderate Risk | Neuropathy OR PVD, no deformity, no prior ulcer | Every 3–6 months |
| High Risk | Neuropathy + PVD and/or deformity, or prior ulcer | Every 1–3 months |
| Critical Risk | Active ulcer, Charcot, or post-amputation | Weekly or biweekly wound care |
Our Wound Care Protocol — Including MLS Laser Therapy
For non-healing diabetic wounds, our protocol includes:
- Sharp debridement at each visit to remove necrotic tissue and stimulate wound bed
- Appropriate offloading: Total contact casting (gold standard), removable cast walkers, or custom offloading footwear
- MLS dual-wavelength laser therapy 2x/week: Accelerates microcirculation, reduces chronic wound inflammation, stimulates cellular ATP production — proven to accelerate wound closure
- Advanced wound care products: Selected based on wound stage (dry/moist, infected/non-infected)
- Glycemic coordination: We communicate directly with your office when wound healing appears limited by glycemic control
Medicare-Covered Diabetic Foot Benefits
Many of your patients are not receiving benefits they’re entitled to. We ensure full utilization of:
- Annual diabetic foot exam (G0245/G0246) — covered for all Medicare diabetic patients
- Therapeutic footwear — shoes + 3 inserts annually for high-risk patients (A5500-A5513)
- Routine foot care (Class Findings) — nail care for patients with qualifying risk conditions
- Wound care services — covered under various codes depending on wound complexity
Our Howell office coordinates with Vassallo Medical Group (same road — Grand River Ave) for patients with diabetes, vascular disease, and systemic conditions. Coordinated care for Livingston County patients.
📞 (810) 206-1402 | Howell, MI
Contact Us for Coordinated Care
We’d welcome the opportunity to establish a formal care coordination relationship with your practice. Call (810) 206-1402 or have your referral coordinator reach out to discuss our workflow.
✅ MLS Dual-Wavelength Laser — FDA-cleared
✅ EPAT Shockwave Therapy — 80%+ success rate
✅ Magnetotransduction (EMTT) — Deep electromagnetic healing
✅ 3D-Scanned Custom Orthotics
✅ Toenail Fungus Laser
✅ In-Office X-Ray & Ultrasound
✅ Diabetic Shoe Program — Medicare-covered
📞 (810) 206-1402 | Howell & Bloomfield Hills
Clinical Foot Care Beyond Products: Michigan’s Balance Foot & Ankle
Michigan patients using foot care products — wound care supplies, topical treatments, foot supplements, compression garments, orthotics, or stretching devices — as part of their foot health routine benefit from occasional clinical evaluation to ensure the products they are using are appropriate for their specific condition and that no developing pathology requires professional intervention. At Balance Foot & Ankle, our clinical evaluation confirms the diagnosis, assesses whether current product-based management is adequate, and identifies cases where professional treatment would produce better outcomes than continued self-management.
For Michigan patients managing chronic conditions — diabetic foot care, neuropathy management, post-surgical recovery, or persistent tendinopathy — regular podiatric check-ins at appropriate intervals ensure that small changes are caught before they become significant complications. The right interval varies by condition and risk level: high-risk diabetic patients benefit from quarterly visits; stable patients using products for minor chronic conditions may need only annual check-ins. At Balance Foot & Ankle, we help patients identify the appropriate visit frequency for their specific situation. Livingston and Oakland County patients can call (810) 206-1402 to schedule at our Howell or Bloomfield Hills office.
Michigan patients can access expert diabetic foot care in Michigan at Balance Foot & Ankle. Our board-certified podiatrists serve Howell (4330 E Grand River) and Bloomfield Hills (43494 Woodward Ave #208). Schedule an appointment online or call (810) 206-1402 for same-week availability.
Related Patient Guides
- Diabetic Foot Care Daily Routine
- Neuropathy Exercises for Feet
- Neuropathy in Feet: Relief Guide
- PAD & Foot Symptoms: Circulation Warning Signs
- 12 Signs You Need to See a Podiatrist
Medical References & Sources
- American Diabetes Association — Foot Complications
- PubMed Research — Diabetic Foot Care
- American Podiatric Medical Association — Diabetic Foot
👟 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 →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 — 30% commission (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.
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Our podiatrists collaborate with endocrinologists to provide comprehensive diabetic foot management. We share treatment plans and coordinate care to optimize your outcomes.
Clinical References
- Boulton AJ, et al. Comprehensive foot examination and risk assessment. Diabetes Care. 2008;31(8):1679-1685.
- Bus SA, et al. IWGDF guidance on the prevention of foot ulcers in at-risk patients with diabetes. Diabetes Metab Res Rev. 2016;32(Suppl 1):16-24.
- American Diabetes Association. Standards of medical care in diabetes — foot care. Diabetes Care. 2023;46(Suppl 1):S203-S215.
Insurance Accepted
BCBS · Medicare · Aetna · Cigna · United Healthcare · HAP · Priority Health · Humana · View All →
Howell Office
3980 E Grand River Ave, Suite 140
Howell, MI 48843
Get Directions →
Bloomfield Hills Office
43700 Woodward Ave, Suite 207
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 AppointmentIn-Office Treatment at Balance Foot & Ankle
If home care isn’t resolving your diabetic foot concern, a visit with a board-certified podiatrist is the fastest path to accurate diagnosis and a personalized plan. At Balance Foot & Ankle Specialists, Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin offer same-day and next-day appointments at both our Howell and Bloomfield Hills offices. We perform on-site diagnostic ultrasound, digital X-ray, conservative care, advanced regenerative treatments, and minimally invasive surgery when indicated.
Call (810) 206-1402 or request an appointment online. Most insurance plans accepted, including Medicare, Blue Cross Blue Shield, Aetna, Cigna, and United Healthcare.
Differential 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.
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
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 Twp. 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 Twp, 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.
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Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon 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 reached over one million views.
Frequently Asked Questions
Can a podiatrist help with neuropathy?
What does neuropathy in feet feel like?
Is foot neuropathy reversible?
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