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James P. Licandro, D.P.M. Diabetes and Podiatry
Why do diabetics need to see a podiatrist?
Why do diabetics need to see a podiatrist? Diabetes is a systemic condition that affects many organs and systems in the body. One of the first places where the effects of diabetes are seen is in the feet. This is due to the fact that the feet have the poorest circulation in the body due to both the effects of gravity causing the blood to pool in the feet and also because the feet are the furthest away from the heart of any structure in the body. It is a well known fact that one of the first systemic conditions that diabetes effects is the circulatory system. Podiatrists specialize in disorders of the foot and ankle and therefore are highly trained to examine for abnormalities of the lower extremity. Many times podiatrists are the first doctors to diagnose vascular disease, and neuropathy (numbness, burning, tingling, pain) in the lower extremities. Diabetes can cause both of these systemic disorders and by seeing a podiatrist, the feet, which are most affected by diabetes, can be cared for on a regular basis. Often a small problem can be diagnosed and treated at an early stage and helps prevent the condition from progressing to a more serious disorder. Why are diabetics at a greater risk for limb loss? Diabetes affects the circulatory system and the lower extremity is the first place this condition is seen. This is due to the fact that whether one has diabetes or not, the feet have the poorest circulation due to the feet being the furthest structures from the heart and also because the blood in the feet has to work against gravity to get back to the heart. As circulation is often compromised in diabetes, the feet and lower extremity are at an even greater risk for infections. An infection as minor as a small cut may take much longer to heal up in a person with diabetes. This is due to not only the compromise in circulation that is often noted in diabetes, but also to the effect diabetes has on the immune system. Diabetes can alter the immune system to the point to where the body cannot properly fight off an infection. Without proper medical attention, a very minor problem can often turn into a major concern and condition. Diabetes has often been called the "Great Masquerader" because it mimics many other medical conditions. Because of this, diabetes is often diagnosed much later than when it first occurred in the body and can lead to further systemic effects. What is the Medicare Diabetic Shoe Program? Dr. Licandro has a strong interest in diabetes and the best treatment protocol for his patients with diabetes. For sometime now, diabetic foot wound infections has been one of the leading causes of hospital admissions and accounts for a high percentage of the reason for lower extremity amputations. In order to help combat this growing disease, in 1993, Medicare approved a therapeutic footwear program for people with diabetes. The program was designed for people with diabetes to be fitted with proper shoe gear and inserts to help not only provide proper fitting shoes, but also to help off load pressure spots in shoes that sometimes lead to corns or calluses. These diabetic patients can qualify for one pair of shoes and three pairs of custom inserts per calendar year. Medicare pays 80% of the total cost. If the patient has a secondary insurance, there is no cost to the patient. Under the Medicare guidelines, the patient needs to be seeing a physician on a regular basis for Diabetes in order to qualify for the program. This physician will be sent a certification form to be signed so that Medicare will cover these specifically approved shoes and inserts. Area Wide Foot and Ankle Center has the approved shoes and inserts. The doctor or one of our highly trained staff will fit you for these therapeutic shoes. Our office completes all the necessary paper work and insurance for this highly effective program. As you may not be familiar with Dr. Licandro, he is a Board Certified Wound Care Specialist and is a member of the American Diabetic Association Educator Program. He is also Board Certified in Podiatric Primary Medical Care and Podiatric Surgery. As a diabetic, how should I care for my feet? It is extremely important to exam your feet daily and check for the following conditions: (If you cannot see the bottom of your foot, lay a mirror on the floor and hold your foot above the mirror to see the bottom.)
See your doctor immediately if you experience any of these conditions. Recognizing a problem and having it treated early is the MOST important factor.
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Area Wide Foot and Ankle Center
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