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What Does a Podiatrist Do for Diabetes?

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What Does a Podiatrist Do for Diabetes?

Whether you’re a “newcomer” to diabetes or you’ve had it for many years, a medical professional that you might consider adding to your diabetes care team is a podiatrist.

Otherwise known as a “foot doctor,” a podiatrist, for many people, is a key part of the healthcare team. Learn more about what a podiatrist does and why you might need one on your team.

What is a podiatrist?

According to the website Vocabulary.com, “The word podiatrist is composed of two ancient Greek parts: pod, meaning ‘foot,’ and iatrist, meaning ‘healer.’” A podiatrist is a Doctor of Podiatric Medicine, or DPM. This type of physician or surgeon is trained to diagnose and treat conditions that affect the feet, ankles and related structures of the leg. Training to become a podiatrist includes four years of undergraduate school, four years at an accredited podiatric medical school, and then three to four years of foot and ankle surgical residency training.

You might be wondering what the difference is between a podiatrist and an orthopedist, or orthopedic doctor. While there is some overlap between the two, a podiatrist only treats foot and ankle conditions, medically and surgically. An orthopedist treats the entire musculoskeletal system, not just feet and ankles (although some orthopedists specialize in the lower extremities, too). In some situations, both podiatrists and orthopedic surgeons are qualified to treat a foot or ankle-related condition, and it’s ultimately a matter of choosing the doctor you feel most comfortable with or who has the most experience in treating the condition.

Like other healthcare professionals, a podiatrist may specialize in a particular area, such as surgery, sports medicine, pediatrics, geriatrics, orthopedics or primary care. Podiatrists treat people with a wide range of chronic conditions, including diabetes, heart disease, arthritis, peripheral arterial disease and obesity. The American Podiatric Medical Association (APMA) states that there are about 18,000 podiatrists practicing in the United States.

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What kind of conditions does a podiatrist treat?

While we sometimes take our feet for granted, it’s amazing (and a little scary) to think of the problems and conditions that affect the feet. Luckily, that’s why we have podiatrists! Podiatrists treat a number of conditions, including:

  • Foot injuries: sprains, fractures, broken bones
  • Foot pain due to arthritis, gout, diabetic neuropathy, metatarsalgia
  • Foot abnormalities: flat feet, hammertoe, bunions, high arches, heel spurs, Charcot foot
  • Heel pain: plantar fasciitis, Achilles tendinitis
  • Skin conditions: calluses, corns, warts, athlete’s foot, psoriasis, fungal infections
  • Nail conditions: ingrown toenails, clubbed nails, toenail fungus, toenail trauma

Why foot care is so important with diabetes

You might be wondering why or how a podiatrist can help someone with diabetes. Taking a “step” back, it helps to understand how diabetes can affect your feet.

Part of diabetes self-management is foot care. Your primary care provider, endocrinologist or diabetes educator may remind you to “check your feet” every day. That’s because diabetes can cause nerve damage, circulation problems and infections that can lead to serious foot problems. A tiny cut on your foot can lead to a foot infection, a foot ulcer, and even an amputation. In fact, if you have diabetes, the lifetime risk for a foot ulcer is 25%; between 9% and 25% of foot ulcers lead to amputation. Fortunately, these problems can be prevented or delayed, but it requires you to take an active role. By checking your feet every day, you can catch issues early on and seek treatment.

How to check your feet

Not sure how to check your feet? Here’s how:

  • Sit down and remove your shoes and socks.
  • Check the tops, bottoms and sides of your feet; also check between your toes.
  • If you have trouble reaching or seeing your feet, have your spouse or partner check for you, or use a mirror to help you see the bottoms of your feet.
  • Look for blisters, cuts or sores.
  • Check for dry or cracked skin, corns and calluses, a rash or athlete’s foot.
  • Feel your feet: Are they hot or cold? Do they look red, blue or pale? Is there a loss of hair on your feet, toes and lower legs?
  • Notice if there is any pain, tingling, burning or swelling in your feet, or if the shape of your foot has changed.

If anything doesn’t look or feel right, let your provider know right away. Depending on the issue, your provider may refer you to a podiatrist for further diagnosis and treatment.

Caring for your feet

Taking care of your feet is also important. That means:

  • Washing your feet every day in warm water and not soaking your feet. Dry your feet thoroughly and apply lotion to your feet, except between your toes.
  • Always wearing shoes and socks or slippers, even when you’re at home.
  • Wearing shoes that fit properly.
  • Trimming your toenails straight across (if you can’t trim your toenails, a podiatrist can do this for you).
  • Avoiding “bathroom” surgery, such as removing corns, calluses or warts yourself.
  • Making sure your provider checks your feet at every regular visit.

How a podiatrist can help you

Not everyone with diabetes needs to see a podiatrist. However, if you have any issues with your feet (especially issues that could be related to diabetes), it’s a good idea to work with a podiatrist. When a podiatrist is involved with your care, your risk of amputation and hospitalization can dramatically decrease, according to the American Podiatric Medical Association. A podiatrist can:

  • Assess for nerve damage. This may include quantitative sensory testing or electromyography (EMG).
  • Order imaging tests, such as X-ray, ultrasound, CT scans and MRIs to detect bone fractures, blocked blood vessels and other structural issues.
  • Treat problems such as foot ulcers, ingrown toenails, fungal infections, bunions and inflamed ligaments or tendons.
  • Correct structural abnormalities, such as hammertoes, bunions or flat feet.
  • Treat foot injuries, cuts, sores and blisters.
  • Recommend proper shoes. In some cases, a podiatrist may recommend prescription footwear to accommodate a foot abnormality, foot ulcers or other issues.
  • Cut your toenails if you are unable to do so.
  • Provide education on caring for your feet.

Your primary care provider can certainly help with these issues, as well, but a podiatrist is specially trained to treat problems of the feet and lower legs; they can also spot early signs of potential trouble and take steps to prevent them from worsening.

Finding a podiatrist

If you would like to see a podiatrist, start with your primary care provider. He or she can likely recommend a podiatrist that is part of your health plan. You may need a referral to see a podiatrist, too.

You can also find a podiatrist online through The American Board of Podiatric Medicine or the American Podiatric Medical Association. Be sure to check and make sure that the podiatrist participates in your health plan unless you are willing to pay out of pocket.

Questions for a podiatrist

Before deciding on a podiatrist, do your homework. Consider asking questions, such as:

  • Do you specialize in or have experience treating people with diabetes?
  • Are you board-certified?
  • Are you accepting new patients?
  • Do you offer telehealth (virtual) visits?
  • Is the office handicap accessible?
  • What are the office hours?
  • What hospitals are you associated with?

Tips to prepare for a podiatrist appointment

Once you have your podiatry appointment scheduled, prepare for your visit. Some tips include:

  • Making a list of symptoms and questions
  • Having a list of the name and doses of your medications
  • Having results of tests, such as lab work, X-rays, MRIs, etc., unless the podiatrist has access to these as part of your network
  • Bringing someone with you to the appointment, if possible
  • Wearing or bringing your walking or exercise shoes with you to the appointment

Don’t be shy about letting the podiatrist know about your blood sugars, A1C, if you smoke, or any symptoms or issues that you are worried about. This is all important information that will help the podiatrist help you!

Want to learn more about keeping your feet healthy with diabetes? Read “Caring for Your Feet When You Have Diabetes,” “How to Choose Footwear” and “Improving Blood Flow to the Feet.”

Amy Campbell, MS, RD, LDN, CDCES

Amy Campbell, MS, RD, LDN, CDCES

Amy Campbell, MS, RD, LDN, CDCES on social media

A Registered Dietitian and Certified Diabetes Educator at Good Measures, LLC, where she is a CDE manager for a virtual diabetes program. Campbell is the author of Staying Healthy with Diabetes: Nutrition & Meal Planning, a co-author of 16 Myths of a Diabetic Diet, and has written for  publications including Diabetes Self-Management, Diabetes Spectrum, Clinical Diabetes, the Diabetes Research & Wellness Foundation’s newsletter, DiabeticConnect.com, and CDiabetes.com

 

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