Why Foot Health Is a Priority in Diabetes

Diabetes is the leading cause of non-traumatic lower extremity amputations in the United States — responsible for approximately 70,000 amputations per year. The majority of these are preventable with proper foot care, regular podiatric monitoring, and early treatment of problems before they escalate. People with diabetes have a 15–25% lifetime risk of developing a foot ulcer, and once a foot ulcer develops, the risk of amputation increases dramatically.

At Balance Foot & Ankle in Howell and Bloomfield Township, Michigan, diabetic foot care is among our most critical services. Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin specialize in comprehensive diabetic foot management.

The Diabetic Foot Triad: Understanding the Risk

Three interacting problems create the high-risk diabetic foot:

• Peripheral Neuropathy: Loss of protective sensation means patients don’t feel pressure, friction, heat, or injury. Small wounds and infections develop unnoticed.
• Peripheral Arterial Disease (PAD): Reduced blood flow impairs wound healing, immune response, and infection control. Even minor injuries may not heal.
• Immunopathy: Elevated blood glucose impairs white blood cell function, reducing the body’s ability to fight infection.

Each factor is serious alone; together they create a scenario where a blister from a new shoe can progress to osteomyelitis and amputation within weeks if untreated.

Daily Foot Self-Inspection Protocol

Every diabetic patient should inspect their feet daily — ideally in good lighting, using a mirror or a family member’s help to see the bottom of the foot. Look for:

• Any cuts, breaks, or cracks in the skin — even small ones
• Blisters or calluses that are developing
• Redness, warmth, or swelling anywhere on the foot
• Discoloration — especially darkening of any area
• Any open wound or sore — no matter how small
• Nail changes — ingrown nails, thickened nails, nail infections

Rule: Any break in the skin of a diabetic foot should be seen by a podiatrist within 24–48 hours. Do not wait to see if it heals on its own.

Nail Care for Diabetics

• Trim nails straight across — never curve into the corners (prevents ingrown nails)
• File sharp edges with an emery board
• Never trim nails shorter than the tip of the toe
• If you cannot see or reach your nails safely — see a podiatrist for routine nail care
• Never use sharp instruments to self-treat ingrown nails
• Never use corn-removing chemicals or blades on diabetic feet

Footwear Requirements for Diabetics

Footwear is the single most modifiable risk factor for diabetic foot injury:

• Never go barefoot — even indoors. One step on a small object can cause a non-healing wound.
• Wear well-fitting shoes with a wide, deep toe box, no internal seams, and soft uppers
• Always check inside shoes before putting them on — shake out foreign objects
• Replace worn shoes promptly — loss of cushioning increases plantar pressure
• Break in new shoes gradually — no more than 1–2 hours the first day
• Medicare and most insurers cover therapeutic diabetic footwear for qualifying patients — ask your podiatrist

Skin and Moisture Management

• Wash feet daily in lukewarm water (test temperature with elbow — neuropathy means you can’t feel burning water)
• Dry completely between toes — moisture breeds fungal infections
• Moisturize the tops and bottom of feet daily — but never between the toes
• If feet are excessively sweaty, use antifungal powder between toes
• Treat athlete’s foot immediately — breaks in skin from fungal infection are entry points for bacteria

Blood Sugar Control and Foot Health

This cannot be overstated: every percentage point reduction in HbA1c meaningfully reduces neuropathy progression, vascular complications, and wound healing impairment. A patient with an HbA1c of 12% has dramatically higher foot risk than one at 7.5%. Work closely with your endocrinologist or primary care physician for optimal glucose management alongside your podiatric care.

How Often Should Diabetics See a Podiatrist?

• Low risk (no neuropathy, no PAD): Annual foot exam
• Moderate risk (neuropathy OR PAD present): Every 3–6 months
• High risk (neuropathy + PAD, prior ulcer or amputation): Every 1–3 months
• Active wound: Weekly or more often as directed

Start Your Diabetic Foot Program Today

If you have diabetes and haven’t had a comprehensive foot exam in the last year — schedule one now. At Balance Foot & Ankle, we perform thorough neurovascular assessments including monofilament testing, vibration threshold testing, ankle-brachial index (ABI), and comprehensive biomechanical evaluation. Our goal is to keep you walking, active, and amputation-free for life.

Foot or Ankle Pain? We Can Help.

Balance Foot & Ankle — Howell & Bloomfield Township, MI

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📞 (810) 206-1402

Dr. Tom Biernacki, DPM

Affiliate Disclosure: This page contains affiliate links to products we recommend. If you purchase through these links, Balance Foot & Ankle may earn a small commission at no additional cost to you. We only recommend products we use with our patients.

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.