Balance Foot & Ankle - Diabetic Foot Disease

Explainer: How Diabetic Foot Disease Can Lead To Amputations And Even Death

Explainer: How Diabetic Foot Disease Can Lead To Amputations And Even Death

Source: The Conversation


People with diabetes are prone to foot disease, which can lead to amputations and even death. Australia has the second-highest rate of lower-limb amputations in the developed world – with the rate having risen by 30% over the past decade.

This is because as rates of type 1 and 2 diabetes increase, so do the very common related problems of foot health – known as Diabetes-Related Foot Disease (DRFD).

Five-year survival rates for those with diabetic foot problems are lower than for prostate, breast and colon cancer, yet the severity of the problem isn’t widely recognized.

If you are one of the estimated one million Australians with diabetes, paying close attention to your foot health could save you from serious, sometimes devastating complications.

How does diabetes cause foot disease?

The most common type of foot disease related to diabetes, affecting up to a quarter of diabetes sufferers, is foot ulcers. These are actually a big financial burden as well. Of the US$116 billion allocated for diabetes care in the United States in 2007, one-third was directed to treat foot ulceration. Here’s why it happens.

Diabetic skin contains less of the structural protein collagen than normal skin. This means it becomes fragile, stiff and more prone to breaking. So a diabetic is more likely to experience injury and poor wound healing.

Diabetes also increases a person’s risk of developing poor blood circulation by up to four times. Stiffer blood vessels restrict blood supply to tissues in the body. When circulation is poor, injuries such as cuts and blisters are less able to heal and more likely to become infected or turn into ulcers.

Wounds related to diabetes most commonly happen on the extremities (feet and lower legs) because these areas are the first to lose feeling and blood supply. The forces of walking and pressure from footwear can also cause damage to the tissues in these areas.

Once a wound has occurred, abnormalities in diabetic cells also prevent healing in the usual way. Although a diabetic’s wound usually contains the cells needed for it to heal, these are often not present in the right amounts or at the right time.

The longer the wound remains unhealed, the more susceptible it is to infection from opportunistic bacteria.

Those with diabetic foot disease often have reduced feeling, or complete loss of it, in their feet – known as peripheral neuropathy. This means they are less likely to notice trauma such as blisters from a rubbing shoe.

A minor injury, such as a small cut, can quickly develop into an ulcer. Peripheral neuropathy has been shown to contribute to 90% of foot ulcers.

These are notoriously difficult to heal and reoccur in up to 70% of cases. Experts consider those with a healed foot ulcer to be in a state of remission needing careful ongoing monitoring.

How foot disease can be prevented

Men are more at risk of developing diabetic foot disease than women.

Other risk factors include living with diabetes for more than ten years, being older, smoking and drinking alcohol, kidney disease and high blood pressure.

Although foot disease in diabetes is a severe problem, there are simple and relatively accessible ways to reduce its rate and severity.

The first basic preventive strategy is for every diabetic patient to request a comprehensive foot examination.

This is often carried out by a podiatrist but any suitably skilled health professional such as a GP or diabetes educator can do so. The health professional will examine the feet, looking at circulation, sensation and footwear.

Ideally, those at risk of ulcers should be managed by a foot protection program. This is a designated podiatrist-led service for preventing, treating and managing diabetic foot problems. It includes education about caring for feet, a podiatry review and appropriate footwear. Such programs can reduce the chance of amputation by 85%.

Unfortunately, foot-screening rates in Australia are low. Only around 20% of those with diabetes get regular foot checks. And foot-protection programs are in their infancy, while specialist footwear is often too expensive for the average person.

Personal technology devices are playing a role in preventing and managing foot disease in diabetes. Smartphone technology and activity monitors, such as iPhones and Fitbits, can help monitor gait patterns and physical activity in those at risk of ulceration. This information can be integrated with specialist apps to modify lifestyle, activity and footwear.

Combining innovative, widely available technology with professional screening and management strategies can prevent the catastrophe foot ulceration represents.

Balance Foot & Ankle - Ingrown Toenail

Diabetes Foot Care

Diabetes Foot Care

Source: WebMD
You’re more likely to have foot problems with diabetes because it can damage your nerves and lessen blood flow to your feet. The American Diabetes Association estimates that it’s the reason why 1 in 5 people with diabetes who seek hospital care do so.You have to take care of your feet when you have diabetes. Poor foot care may lead to amputation of a foot or leg.Your doctor will check yours each year for problems. If you take good care of your feet, you can prevent most serious problems related to diabetes.

Wash and Dry Your Feet Daily

Use mild soaps and warm water.

Pat your skin dry; do not rub. Thoroughly dry your feet.

After washing, put lotion on them to prevent cracking. But not between your toes!

Check Your Feet Every Day

Look carefully at the tops and bottoms of your feet. Have someone else do it if you can’t see them.

  • Check for dry, cracked skin.
  • Look for blisters, cuts, scratches, or other sores.
  • Check for redness, increased warmth, or tenderness when you touch an area.
  • Watch for ingrown toenails, corns, and calluses.

If you get a blister or sore from your shoes, don’t “pop” it. Put a bandage over it, and wear a different pair of shoes.

Please read the full article here on WebMD

Balance Foot & Ankle - COVID-19 Coronavirus

A Note of Reassurance

A Note of Reassurance

The health, safety and well-being of our patients, visitors, employees, and our community is top priority.

As a medical facility, we already adhere to strict practices and policies of cleaning and sanitation daily. Given the current situation, we are taking additional steps to be extra vigilant and keep our office safe for our patients. These additional measures include increasing the frequency of cleaning all surfaces and areas with antibacterial and antimicrobial cleaning products recommended by the CDC. We have added a medical grade HEPA/HEGA air filter purification unit in our office which filters greater than 95% of all dust, spores, mold, bacteria, viruses, chemicals, and gases larger than 0.100 microns. Scientists say that the size of the Coronavirus is 0.125 microns. Therefore, the air filter purification unit is designed to capture airborne particles of this size. Additionally, masks and alcohol-based hand sanitizer is readily available. Thank you for your understanding and cooperation.

Stay Safe & Healthy –

Dr. Jennifer L. Prezioso, DPM, FACFAS

Balance Foot & Ankle - x-ray Guest Column: The Podiatrist is in! Meet Dr. Jennifer Prezioso Guest Column: The Podiatrist is in! Meet Dr. Jennifer Prezioso

Have you ever found yourself, at the end of an evening, thinking of nothing other than getting home and switching out your gorgeous-but-painful pair of shoes in exchange for an old pair of slippers that has seen better days but never lets you down? If yes, then pull up a chair, have a seat, and welcome home. My name is Dr. Jennifer Prezioso, and I am a shoe lover (and hater) just like you. But, as a Podiatric Surgeon, board certified by the American Board of Foot and Ankle Surgery, I am also a dedicated member of the world of Foot and Ankle specialists striving to help people understand their individual foot type and how to make sure they are making healthy shoe choices. So I not only empathize with those who adore shoes but face footwear challenges, I also advocate for them every day. I recently had the opportunity to write a guest column for on this very topic. If you would like to learn more, read the full article here.



Balance Foot & Ankle

Balance Now Offers Video Visits!

Balance Now Offers Video Visits!

While we love to see you in our office, we realize it’s not always convenient to do so. Video visits allow you to receive the same quality care as you do in the clinic, without taking time off work or finding a sitter to see us.

It’s easy to get started. Next time you’re in the office or need to schedule an appointment, ask for a video visit. Next, look out for an email or text to confirm your information in our telemedicine platform, called Chiron Health. On the day of your visit, simply log in 15 minutes early to see your doctor over video. It’s that easy.

Video Visits are great for:

● Follow-up visits

● Medication questions

● Lab & test results

● General questions and more

Skip the waiting room, request a video visit for your next appointment!

Balance Foot & Ankle - Summer

Tips for Healthy Feet - Summer Foot Care

Tips for Healthy Feet - Summer Foot Care

Source: American Podiatric Medical Association, Inc.


  1. Limit walking barefoot as it exposes feet to sunburn, as well as plantar warts, athlete’s foot, ringworm, and other infections and also increases risk of injury to your feet.
  2. Wear shoes or flip-flops around the pool, to the beach, in the locker room and even on the carpeting or in the bathroom of your hotel room to prevent injuries and limit the likelihood of contracting any bacterial infections.
  3. Remember to apply sunscreen all over your feet, especially the tops and fronts of ankles, and don’t forget to reapply after you’ve been in the water.
  4. Stay hydrated by drinking plenty of water throughout the day. Drinking water will not only help with overall health, but will also minimize any foot swelling caused by the heat.
  5. Keep blood flowing with periodic ankle flexes, toe wiggles, and calf stretches.
  6. Some activities at the beach, lake, or river may require different types of footwear to be worn, so be sure to ask the contact at each activity if specific shoes are needed. To be safe, always pack an extra pair of sneakers or protective water shoes. If your shoes will be getting wet, they should be dried out completely before your next wearing to prevent bacteria or fungus from growing.
  7. If you injure your foot or ankle while on vacation, seek professional medical attention from a podiatric physician. Many often only contact a doctor when something is broken or sprained, but a podiatrist can begin treating your ailment immediately while you’re away from home. Use our Find a Podiatrist tool to get treatment wherever your travels take you!
  8. In case of minor foot problems, be prepared with the following on-the-go foot gear:
    • Flip flops—for the pool, spa, hotel room, and airport security check points
    • Sterile bandages—for covering minor cuts and scrapes
    • Antibiotic cream—to treat any skin injury
    • Emollient-enriched cream—to hydrate feet
    • Blister pads or moleskin—to protect against blisters
    • Motrin or Advil (anti-inflammatory)—to ease tired, swollen feet
    • Toenail clippers—to keep toenails trimmed
    • Emery board—to smooth rough edges or broken nails
    • Pumice stone—to soften callused skin
    • Sunscreen—to protect against the scorching sun
    • Aloe vera or Silvadene cream—to relieve sunburns