Why Diabetic Foot Care Matters

Diabetes is the leading cause of non-traumatic lower limb amputation in the United States. The American Diabetes Association reports that approximately 15% of people with diabetes will develop a foot ulcer during their lifetime, and up to 24% of those ulcers ultimately lead to amputation.

The good news: the vast majority of these complications are preventable with proper foot care, regular examinations, and early intervention. A comprehensive diabetic foot care program reduces amputation risk by 45–85%.

At Balance Foot & Ankle Specialists, diabetic foot care is one of our core specialties. We work closely with your endocrinologist, primary care physician, and vascular specialists to provide coordinated, whole-patient care.

How Diabetes Affects Your Feet

Diabetes creates a dangerous combination of nerve damage, poor circulation, and impaired immune function that specifically targets the feet:

Peripheral Neuropathy (Nerve Damage) — High blood sugar damages the small nerve fibers in your feet, causing numbness, tingling, or burning. When you lose feeling, you cannot detect cuts, blisters, pressure sores, or foreign objects in your shoes. A small wound you cannot feel can progress to a serious infection within days. Learn more about neuropathy treatment →

Peripheral Arterial Disease (PAD) — Diabetes accelerates atherosclerosis, reducing blood flow to the feet and lower legs. Poor circulation means less oxygen, fewer nutrients, and fewer infection-fighting white blood cells reach your feet. Even minor wounds heal slowly or fail to heal entirely. Learn more about PAD screening →

Immune Dysfunction — Elevated blood glucose impairs your immune system’s ability to fight bacteria. Diabetic patients are significantly more susceptible to foot infections, which can spread rapidly to bone (osteomyelitis) and become limb-threatening.

Charcot Foot (Neuroarthropathy) — In severe neuropathy, the bones of the foot can weaken and fracture without pain. Continued walking on a fractured foot causes progressive deformity, creating pressure points that ulcerate. Early detection is critical — untreated Charcot foot leads to permanent disability.

What a Diabetic Foot Exam Includes

The American Diabetes Association recommends a comprehensive foot exam at least once a year for all diabetic patients, and more frequently if you have neuropathy, PAD, or a history of foot ulcers. Our exam includes:

1. Neurological Assessment — We test protective sensation using a 10-gram Semmes-Weinstein monofilament and a 128 Hz tuning fork. Loss of protective sensation is the single strongest predictor of future ulceration. We also assess reflexes and proprioception.

2. Vascular Assessment — We palpate dorsalis pedis and posterior tibial pulses, measure ankle-brachial index (ABI) when indicated, and assess capillary refill time. Reduced blood flow changes your risk category and treatment approach.

3. Musculoskeletal Evaluation — We check for structural deformities (bunions, hammertoes, Charcot changes, flat feet) that create pressure points where ulcers typically develop. Learn about flat feet treatment →

4. Dermatological Inspection — We examine every surface of both feet for calluses, corns, blisters, fungal infections, ingrown toenails, skin breaks, and color changes. Even minor findings like dry cracked skin or toenail fungus require treatment in diabetic patients.

5. Footwear Assessment — Improper shoes cause the majority of diabetic foot ulcers. We evaluate your current footwear and recommend diabetic-appropriate shoes with adequate depth, no internal seams, and proper fit.

6. Risk Stratification — Based on exam findings, we assign a risk category (0–3) per ADA guidelines. Higher risk categories receive more frequent monitoring, custom orthotics, and coordinated vascular care.

Our Diabetic Foot Care Services

We provide a full spectrum of diabetic foot care, from routine preventive exams to advanced wound management:

Preventive Care — Annual and quarterly comprehensive foot exams, neuropathy screening, patient education on daily foot inspection, proper nail care, and moisture management.

Medical Nail Care — Diabetic patients should never trim their own nails with neuropathy. Our medical pedicure service safely manages thickened, fungal, or difficult nails in a clinical setting with sterile instruments.

Custom Diabetic Orthotics — Pressure redistribution is critical for ulcer prevention. We design custom molded orthotics that offload high-pressure areas, accommodate deformities, and fit properly in diabetic footwear.

Wound Care & Ulcer Management — When ulcers develop, rapid intervention determines outcome. We provide sharp debridement, offloading with total contact casting or removable walkers, advanced wound dressings, and infection management with targeted antibiotics.

Ingrown Toenail Treatment — Ingrown toenails are especially dangerous for diabetic patients because they create open wounds vulnerable to infection. We perform in-office nail procedures under sterile conditions with meticulous post-operative care.

Charcot Foot Management — Early detection and immobilization can prevent permanent deformity. We use total contact casting, custom ankle-foot orthoses (AFO), and coordinated surgical planning when needed.

Daily Foot Care for Diabetic Patients

Between office visits, daily foot care is your most powerful defense against complications. Follow these evidence-based guidelines:

1. Inspect your feet every day — Check the tops, bottoms, between toes, and around nails. Use a mirror or ask someone to help if you cannot see the bottoms. Look for cuts, blisters, redness, swelling, calluses, or color changes.
2. Wash feet daily in lukewarm water — Test water temperature with your elbow or a thermometer (below 90°F/32°C). Never soak your feet. Dry thoroughly, especially between toes.
3. Moisturize daily — Apply unscented lotion to tops and bottoms of feet. Do not apply between toes (excess moisture promotes fungal infection).
4. Never go barefoot — Always wear shoes or slippers, even indoors. Check inside shoes before putting them on — shake out any debris.
5. Wear proper socks — Choose moisture-wicking, seamless diabetic socks. Change socks daily. Avoid tight elastic bands that restrict circulation.
6. Do not self-treat corns, calluses, or warts — Over-the-counter products contain salicylic acid that damages diabetic skin. Let your podiatrist handle these safely.
7. Trim nails carefully — Cut straight across, not too short, with clean clippers. If you have neuropathy or difficulty reaching your feet, schedule regular medical pedicures instead.
8. Keep blood sugar controlled — This is the single most important factor in preventing neuropathy progression and promoting wound healing.

Coordinated Vascular Care

For complex diabetic and vascular cases, we partner directly with internal medicine and vascular specialists. Our coordinated care with Vassallo Medical Group provides same-location vascular assessments, ABI testing, and referrals for advanced vascular interventions when needed.

This multidisciplinary approach means you get podiatric and vascular expertise in one coordinated care plan — no gaps between providers, no missed follow-ups, and faster treatment decisions when complications arise.

When to See a Podiatrist Urgently

Contact Balance Foot & Ankle Specialists immediately — do not wait for your next scheduled appointment — if you notice any of the following:

• Any open wound, cut, or blister on your foot that is not healing
• Redness, warmth, or swelling — especially if it is spreading
• Drainage or foul odor from a wound
• Black or blue discoloration of skin on your foot or toes
• Sudden increased pain or, conversely, sudden loss of feeling
• A hot, red, swollen foot (possible Charcot foot — this is an emergency)
• Fever combined with any foot wound
• Ingrown toenail with redness or pus

Call (810) 206-1402 for same-day evaluation. Diabetic foot emergencies are seen as priority appointments.

Why Choose Balance Foot & Ankle for Diabetic Foot Care

• Board-certified podiatrists — Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin specialize in diabetic foot management
• Comprehensive neuropathy screening — Monofilament, tuning fork, and ABI testing at every diabetic exam
• Coordinated vascular care — In-house partnership with vascular specialists for PAD cases
• Advanced wound care — Debridement, total contact casting, and advanced dressings for non-healing ulcers
• Custom diabetic orthotics — Pressure redistribution devices designed specifically for your feet
• Same-day urgent appointments — Diabetic foot emergencies are priority cases
• Two convenient locations — Howell and Bloomfield Hills, serving all of Southeast Michigan
• Insurance-friendly — We accept most major insurance plans including Medicare