Do I Have a Foot Ulcer?

What Is a Foot Ulcer?

Foot ulcers are open sores in your skin that will not heal or keep returning. These sores result from the breakdown of the skin and tissues of the feet and ankles and can get infected. They can be shallow and only involve the surface of the skin, or they may be a deep crater that extends through the skin’s thickness and involves tendons and bones.

People with diabetes or poor circulation are more likely to develop foot ulcers. Foot ulcers can be challenging to heal, and in people with diabetes or poor circulation, even the smallest of cuts can turn into infected ulcers with much more serious consequences. It may take weeks or even several months for foot ulcers to completely heal.

Foot and ankle ulcers usually fall into one of three major types.

  • Neurotrophic (diabetic) ulcers
  • Arterial (ischemic) ulcers
  • Venous ulcers

Health risks and conditions that can increase the risk of developing a foot ulcer include:

  • Diabetes
  • Neuropathy
  • Blood circulation problems
  • Heart disease
  • Obesity
  • Kidney disease
  • Alcohol use
  • Tobacco use

The most common causes of foot ulcers include:

  • Trauma to the foot or toe
  • Cellulitis — a bacterial infection
  • Neuropathy from Diabetes
  • Friction when your feet or toes rub against your socks or shoes.
  • An unusual walk that puts too much pressure on a particular part of your toe or foot.
  • Poor circulation
  • Toe or foot deformities — While not the cause of ulcers, foot and toe ulcers are frequently found in conjunction with certain deformities like hammertoes, mallet toes, and claw toes.

Neurotrophic or Diabetic Foot Ulcers

Anyone who has diabetes can develop a diabetic foot ulcer. Diabetic foot ulcers occur in approximately 15 percent of patients with diabetes. These ulcers are usually located on the bottom of the foot.

  • Of those who develop a foot ulcer, six percent will be hospitalized due to infection or other ulcer-related complications. 
  • 14 – 24 percent of people with diabetes in the U.S. need an amputation after they get an ulcer

Diabetes is the leading cause of nontraumatic lower extremity amputations in the United States.

These ulcers are usually a product of diabetic neuropathy, a condition that causes you to lose feeling in your feet. Even the smallest scrapes, blisters, or cuts in your skin can eventually turn into an ulcer. Patients with diabetes might not even realize they have an injury to their foot because of the neuropathy.

Arterial Ulcers

Arterial ulcers are usually found on skin over pressure points like the tip of the toe, the heel, or the inner side of the ankle bone. They can occur at the site of an injury, even small ones. 

Arterial skin ulcers result from poor blood flow in the lower leg and an injury on the leg or foot. 

Arterial ulcers can form on many different parts of your body, like your heels, between your toes, or on the bony parts of your feet or ankles that rub against your socks, shoes, or even your bed sheets. They can be yellow, brown, grey, or black. Often, the borders of these ulcers appear taller than the ulcer itself. These ulcers don’t bleed and are typically very painful, especially at night.

Venous Ulcers

These ulcers affect the legs below the knees. They are usually found in individuals with a history of vein conditions and leg swelling. They most commonly form around the ankles because of an increase in blood pressure due to damage to the valves inside the leg veins.

Varicose veins and chronic venous insufficiency can also cause them.

How Do I Tell if I’m Getting a Foot Ulcer?

Foot ulcers may appear like a wound on the flesh of the foot, like a red crater. It’s important to pay attention to changes in the skin. Don’t just rely on your sense of feel. If you’re suffering from a circulation problem or nerve damage, you may not feel certain symptoms.

Remember to check your feet and toes for signs of an ulcer. If you’re unable to examine your feet, ask a family member or caretaker to help you.

The following are symptoms you may notice if you’re suffering from a diabetic foot ulcer:

  • Swelling
  • Skin discoloration — skin that is pink, red, brown, black, or a combination of these colors.
  • Redness
  • Itching
  • Rashes
  • Scaly skin
  • Cracked skin
  • Dry skin
  • Pain

In more advanced instances, you may also start to notice:

  • A callous that is on top of the ulcer.
  • A blister
  • Drainage on your socks. Pus and drainage is a sign of infection.
  • An area of skin that’s warmer than the surrounding area
  • A halo or ring around the center of the wound that feels harder than the skin surrounding it.
  • Brown discoloration
  • Odor
  • Increased pain
  • Fever or chills

Your primary healthcare provider may diagnose an ulcer, but you may be sent to a specialist, like a podiatrist, for treatment. Your doctor may use X-rays, CT scans, or MRIs to determine how deep your ulcer goes or to see if an infection has spread to the nearby bones.

How Are Foot Ulcers Treated?

It is important to see a podiatrist for ulcer treatment. You should not attempt to treat an ulcer yourself. There are both conservative and surgical treatment options. If more conservative treatments don’t work, your podiatrist may advise surgery, especially if the ulcer is infected.

Ulcer treatment options include:

  • Wound care — medication and dressing changes. 
  • Antibiotics
  • Debridement — removal of the dead skin and tissue. Your provider may wash out the ulcer during this process.
  • Compression
  • Grafts
  • Off-loading — Your podiatrist may suggest wearing special shoes, a brace, a special cast, crutches, or even a wheelchair to reduce pressure on the ulcer.
  • Orthotics — the same concept as off-loading. Orthotics will help redistribute your body weight.

As cliche as it sounds, the best treatment for an ulcer is prevention. Ulcers can take many months to heal, and for patients with diabetes or circulatory issues, ulcers can turn into a reason for hospitalization and eventual amputation.

Incorporate a daily foot check into your routine if you have any underlying medical conditions that make you more susceptible to developing a foot or toe ulcer. If you notice any changes in your foot health, get in touch with our office today to get scheduled with one of our podiatrists in Missoula or Hamilton.

Person walking on sand. Bottom of foot and heel visible.

Heel Pain? It Could Be Plantar Fasciitis

What is Plantar Fasciitis?

Are you experiencing pain at the bottom of your heel? Few things in life can completely disrupt normal daily living quite so much as foot pain that keeps you from moving around and doing the things you love.

Plantar fasciitis typically causes a dull ache or a stabbing pain on the bottom of your foot near the heel. This pain is usually the most severe when you take your first few steps in the morning or after you’ve been sitting for a while. 

Plantar fasciitis is one of the most common causes of heel pain, and more than 2 million people in the U.S. are treated for it each year. Around 10% of people will experience plantar fasciitis at some point. 

The plantar fascia is a band of tissue on the bottom aspect of your foot that runs from the ball of your foot to the heel and connects your heel bone to the base of your toes. You might not think often about this band of tissue, but it plays an important role in foot mechanics. It supports the arch of your foot and absorbs shock when you walk.

Plantar fasciitis can happen when your plantar fascia is inflamed, overused, or stretched too far. 

What Are The Symptoms of Plantar Fasciitis?

Symptoms of plantar fasciitis usually affect one foot at a time and can develop gradually or suddenly after intense physical activity. Recognizing the symptoms of plantar fasciitis can help with early intervention and is essential for proper management. 

It’s key to keep in mind that each person is different. The duration and severity of symptoms will vary from person to person.

Here are some of the most common symptoms of plantar fasciitis:

  • A dull ache or stabbing pain on the bottom of your foot, near the heel. 
  • Pain, aching, or burning in the arch of your foot.
  • Heel discomfort and pain after getting out of bed in the morning or after extended periods of inactivity.
  • Heel or foot pain that gets worse after physical activity but is not usually experienced during exercise. 
  • Tenderness near the heel when touching.
  • Stiffness in the foot and heel. This makes climbing stairs particularly difficult.
  • Pain is more intense in bare feet or in shoes with minimal support.
  • A tight Achilles tendon.

Risk Factors of Plantar Fasciitis

Plantar fasciitis can develop without any obvious cause. However, some factors can increase your risk of developing this condition. These can include:

  • Occupations that keep you on your feet. People who spend many hours a day on their feet walking or standing on hard surfaces are at risk of developing plantar fasciitis.
  • Age — Plantar fasciitis is most common in individuals between the ages of 40 and 60.
  • Obesity — Carrying around extra pounds can lead to the onset of plantar fasciitis.
  • Foot Mechanics — High arches, flat feet, and even an atypical gait can affect the way your weight is distributed when you’re standing. This can put added stress on the plantar fascia.
  • Wearing shoes like flip flops or flat shoes that don’t support your feet.
  • Exercising without warming up or stretching.
  • Long-distance running. 
  • Having a tight Achilles tendon.

Plantar Fasciitis Treatment

There are both conservative and surgical treatment options to help with plantar fasciitis pain. Speak with your podiatrist to discuss what the best option is for you. Conservative treatment is typically a combination of a few different things. It’s usually a combination of stretching, support, and rest to the fascia that will provide the tissue with time to heal.

  • Orthotics — Adding inserts into your shoes that offer extra support can help with this condition. Your podiatrist will either suggest a pre-made insert you can buy over the counter or custom-made orthotics that are made specifically for your foot. If you see one of our podiatrists at Western Montana Foot and Ankle, this scan will be done digitally.
  • Wearing Supportive Shoes — Don’t walk bare feet. Avoid wearing sandals, flip-flops, or other flat shoes with little to no arch support. Instead, wear well-cushioned, sturdy shoes.
  • Stretching & Physical Therapy — There are certain stretches and massage techniques your provider or physical therapist can show you to help your plantar fasciitis pain. They can also help by showing you exercises to strengthen your lower leg muscles, which will help lessen the pressure and workload on your plantar fascia.
  • Icing — Icing your foot twice a day for 10 to 15 minutes may help with inflammation.
  • Medication — Taking medications like aspirin, ibuprofen, and naproxen, otherwise known as NSAIDs (non-steroidal anti-inflammatory drugs), can help reduce pain and inflammation.
  • Rest  — Take a break from the activity that has caused your plantar fasciitis pain. This can also sometimes mean wearing a walking boot to hold your foot in place and take pressure off your plantar fascia.
  • Local Injections —  steroid injections can decrease inflammation. This can be done at your podiatrist’s office.
  • Surgery — It’s rare to need surgery, but when conservative treatment methods have failed to alleviate your plantar fasciitis pain, it may become an option. The two most common types of surgery help with plantar fasciitis pain by either lengthening your calf muscle to reduce pressure on your plantar fascia or relieving tension by having tiny incisions made in the plantar fascia.

What Can I Do to Prevent Plantar Fasciitis?

Your plantar fasciitis symptoms should start improving as soon as you start treating them. This can take anywhere from a few weeks to many months, depending on the severity of your condition.

Here are a few things you can do to prevent plantar fasciitis:

  • Wear supportive shoes — this also means replacing your sneakers every six to nine months, depending on how much you use them.
  • Stretch before and after exercise.
  • Don’t walk barefoot on hard surfaces.
  • Incorporate low-impact exercises into your routine. Swap out daily running with a rotation of swimming or bicycling instead.
  • If you’re overweight, work on losing weight to reduce pressure on your plantar fascia.

See a Podiatrist for Your Plantar Fasciitis Pain

Ignoring plantar fasciitis can lead to chronic heel pain that gets in the way of your regular activities. It can be frustrating to hear you need to take a break from your favorite activities, but it’s important to give yourself time to recover and heal.

If you ignore your symptoms and deal with plantar fasciitis too long, it can lead to gait changes as you try to avoid plantar fasciitis pain. This can lead to foot, knee, hip, or back pain.

Podiatrists have more specialized education and experience with plantar fasciitis and other foot and ankle conditions than any other healthcare professional. If you’re suffering from heel pain get in touch with Western Montana Foot and Ankle today and get scheduled to see one of our podiatrists.

What Is a Matrixectomy? Do I Need One?

Why Would I Need a Matrixectomy?

Do you consistently get ingrown toenails? Or maybe you have an ingrown toenail that lingers and won’t seem to go away. Ingrown toenails can be painful and keep you from enjoying your daily activities.

Ingrown toenails can happen to anyone at any age. They can result from incorrect toenail trimming, injury to the nail, shoes that don’t fit correctly, and toenails that are naturally more curved than others.

Ingrowns can range from a mild inconvenience to something much more painful. Problems arise when an ingrown toenail becomes infected. It is vital to see your podiatrist after noticing an ingrown toenail if you have circulatory issues or are a diabetic.  

If you want to learn more about ingrown toenails, take a look at our blog, which goes into more detail about the causes of ingrowns and how to prevent and treat them.

For pesky ingrown toenails that repeatedly come back or for those that don’t respond to conservative treatment or a nail avulsion, a matrixectomy may be the answer.

So, What’s a Matrixectomy?

A matrixectomy is a permanent solution to an ingrown toenail that has a high success rate. During the minimally invasive outpatient procedure, a podiatrist will remove the problem portion of your toenail. This will be the portion of your toenail that is growing downwards or inwards and is piercing the skin of your toes and causing your painful symptoms.

To prevent that portion of the nail from growing back, the nail matrix, or base of the nail, is treated with either surgical methods, a laser, or a chemical solution that scars the matrix and makes sure that portion of the nail does not grow back again.

This simple procedure will typically leave you with a slightly narrower toenail, but a toenail that usually still looks “normal” after the procedure and hopefully won’t become ingrown again.

What Should I Expect When Having a Matrixectomy?

If you have a matrixectomy scheduled, there’s no need to worry or stress about the procedure. It’s a straightforward and common procedure. Any questions you have can be answered by your podiatrist.

Here are a few things you should expect during a matrixectomy.

  • A matrixectomy is an outpatient procedure done in the clinic.
  • Your toe will be cleaned and prepped for the procedure.
  • A matrixectomy is performed under local anesthetic.
  • Some sort of constricting band is placed around your toe to limit blood flow to the area during the quick procedure. 
  • Your podiatrist will gently lift the ingrown portion of the toe out from under the skin and then cut and remove that problematic portion of the nail.
  • Your podiatrist will then treat the nail bed so that portion of the nail does not grow back again.
  • The procedure itself is quick, and your total appointment time will usually not exceed 45 minutes.
  • You do not need a special boot or brace while your toe is healing.
  • Most people don’t need to take any additional time off work or school to heal from the procedure.
  • Your toe will usually heal within a couple of weeks of having the procedure.
  • Once the local anesthetic wears off, you may experience a small throbbing pain or discomfort that can last for a couple of days. This can be remedied with the use of over-the-counter pain relief medications.
  • You will most likely experience some tenderness after a matrixectomy.
  • Make sure to follow the aftercare instructions provided by your podiatrist.

The procedure is 95% effective at ensuring the nail, or partial portion of the nail, is permanently removed. But sometimes, the nail does grow back, and this can cause pain. If this does happen, the procedure can be done again and is usually effective the second time around at ensuring the nail does not regrow.

Are You Looking for a Podiatrist in the Missoula, MT Area?

Podiatrists specialize in foot and ankle conditions and have more experience dealing with ingrown toenails than any other healthcare professional. Whether you’re suffering from an ingrown toenail, bunions, plantar fasciitis, or general foot pain, our podiatrists at Western Montana Foot and Ankle can help. With offices in Missoula and Hamilton and an additional outreach clinic in Plains, you shouldn’t let traveling concerns keep you from getting the help you need for a variety of foot and ankle conditions. 

If you’re ready to schedule an appointment, call our Missoula office at 406.543.5333 or our Hamilton office at 406.363.7289.

Do I Have an Ingrown Toenail?

What’s an Ingrown Toenail?

Ingrown toenails are a common foot condition where the toenail is curved and grows into the skin. This most commonly happens at the sides of the nail at the nail borders on the big toes. This digging in of the toenail can cause skin irritation, soreness and pain, redness, swelling, warmth of the toe, and even infection.

The medical term for an ingrown toenail is onychocryptosis. Infection can occur if the ingrown nail causes a break in the skin and bacteria get in. An infection caused by an ingrown toenail is often characterized by drainage and foul odor.

You can do different things at home to treat an ingrown toenail. But it’s important to skip the home remedies and see your podiatrist immediately if you suspect an infection or have diabetes, circulation problems, or numbness in the toes.

You may be setting the stage for ingrown toenails yourself. Read on to learn about this common but pesky foot condition.

What Causes an Ingrown Toenail?

There are many possible causes of an ingrown toenail. They can include:

  • Improper nail trimming
    • If you cut your toenail too short or rounded, the nail may grow into the skin.
    • Many people trim their nails so the nail curves with the shape of their toes, but this encourages the toenail to grow into the skin of your toe.
  • Poorly fitting shoes
    • Shoes that are too tight, narrow, or short.
    • High heels transfer most of your body weight toward the front of your foot and put a lot of pressure on your big toes.
  • Toe trauma
    • Ingrown toenails can be a result of trauma. Toenail trauma may include stubbing your toe, having a heavy object fall on your toe, or having the toe stepped on.
  • Genetics
    • You can thank your parents for this one if you’re one of many people in which the tendency for ingrown toenails is inherited.
  • Nail conditions
    • You may be more prone to ingrown toenails if you have a nail condition such as a fungal infection or psoriasis.
    • Toenails tend to curve and thicken as we age.
  • Repetitive pressure from certain sports

Improper nail trimming and poorly fitting shoes are the most common causes of ingrown toenails. But be aware that ingrowns have many causes and can be a condition that develops over time.

Ingrown toenail being worked on by gloved hands and tool

What Are the Symptoms of Ingrown Toenails?

Any of your toenails can become ingrown, but this nail condition most commonly affects the big toe. When you first have an ingrown toenail, it may feel hard and swollen.

Some symptoms of an infected ingrown toenail can include:

  • Swelling
  • Pain
  • Liquid or pus coming out of your toe
  • Redness or darkening of the area
  • Toe feeling warm or hot
  • Odor

Home Treatment for Ingrowns

If you suspect you have an ingrown, it is not infected, and you don’t have a complicating medical condition like diabetes or other circulatory disorders, you can soak your foot in lukewarm water with Epsom salts two or three times a day for 15 minutes. Massage the skin at the side of the toenail, gently pushing it away from the nail. Make sure you dry your foot thoroughly after each soak.

There are a few important things to remember if you are going to treat your mild ingrown toenail at home:

  • Do not cut a notch in the nail.
  • Refrain from trimming nail borders. 
  • Over-the-counter medications will not be effective in treating ingrowns. Topical medications may help mask the pain, but they do not fix the problem.

Do not attempt to remove any part of an infected nail. You should see your podiatrist, who can diagnose and properly treat nail problems.

Two feet and lower legs soaking in a bath tub

When Should I See a Podiatrist for My Ingrowns?

If the toenail isn’t better after three to five days of conservative, at-home care, or it becomes infected, you should schedule an appointment with your podiatrist. You may need to take an oral antibiotic for the infection, and your podiatrist may need to remove the ingrown part of the nail.

If you notice drainage, pain, or excessive redness around the toenail, you should schedule an appointment with your podiatrist right away.

Remember, if you have diabetes or poor circulation, you should see your podiatrist immediately at the first signs of an ingrown toenail, as it can lead to more serious foot and health complications due to poor circulation and damaged nerves in the feet.

Your podiatrist will remove the ingrown portion of the nail. This is called an avulsion. They may also prescribe medication to treat the infection.

In more severe cases, your podiatrist may have to perform a total avulsion and remove all of your toenail. It can take a few months for your nail to regrow.

If you experience ingrowns that keep occurring, your podiatrist may suggest a matrixectomy. During a matrixectomy, your podiatrist not only removes a portion (or all) of the ingrown toenail, but they also treat the base of the nail (called the nail matrix) with a chemical that prevents the nail from growing back again.

How to Prevent Ingrown Toenails?

Here are a few things you can do to prevent getting ingrown toenails:

  • Don’t rip or tear your nails.
  • Don’t round the corners of your toenails to match the shape of your toe when you’re trimming them. Trim your nails straight across.
  • Wear shoes that fit correctly.
  • Don’t trim your toenails too short.
    • Don’t trim the nails any shorter than the edge of the toe.
  • Check your feet!
    • If you have diabetes, you should check your feet regularly for signs of ingrown toenails and other foot problems. 
  • Wear protective footwear.
    • If your job or other activities put you at risk of injuring your toes, you should wear protective footwear.
  • See a podiatrist to regularly have your nails trimmed if you can’t trim them yourself or if you have a condition that causes poor circulation in your feet.

Having an ingrown toenail can be a mild inconvenience or a very painful experience. Our podiatrists at Western Montana Foot and Ankle have more specialized training and experience treating ingrown toenails than any other medical professional.

If you’re suffering from an ingrown toenail, don’t hesitate to get help. Reach out to our office and get scheduled to see one of our podiatrists.

Diabetes and Your Feet — The Importance of Diabetic Foot Care

You Have Diabetes. Now What?

So, you’ve just been diagnosed with diabetes. There’s a lot for you to manage. You must check your blood sugar, be active, stay on top of your medications, make healthy food choices, and so much more. It can be overwhelming, to say the least.

With so many things going on, your feet might be at the bottom of your priority list. However, approximately half of all people with diabetes have some sort of nerve damage, a common complication of diabetes. You might not be thinking about your feet at all. But you should be! Diabetic foot problems are a major health concern for someone with diabetes. If ignored, diabetic foot complications can cause hospitalization.

Daily care is the best form of prevention when it comes to foot complications and diabetes.

What is Neuropathy?

There are various types of neuropathy, but we’re going to focus on two:

  • Diabetic neuropathy — nerve damage caused by diabetes. Over time, high blood glucose levels can damage your nerves. 
  • Peripheral neuropathy — a specific type of nerve damage that includes any nerve damage outside the central nervous system. Think of your feet, legs, arms, and hands.

Neuropathy can cause tingling, pain, and numbness in your feet. When you lose feeling in your feet, you will not feel things you usually would. Nerve damage can lower your ability to feel pain, heat, or cold. 

That doesn’t sound too bad, right? But living without pain in your feet comes at a steep price. Pain is the body’s way of telling you something is wrong. You might not feel things like a small rock in your shoe or a blister on your foot. This can lead to cuts, sores, and even more serious issues if those cuts and sores become infected and turn into ulcers.

Factors That Increase Your Risk of Nerve Damage:

  • High blood sugar levels that are difficult to manage
  • Being overweight
  • Being older than 40
  • Having elevated cholesterol and/or high blood pressure
  • If you’ve had diabetes for an extended period of time
A woman in yoga pants. Two bare feet on a yoga mat.

How Can Diabetes Affect My Feet?

Diabetic foot complications are a common cause of hospitalization. Foot complications affect more than 20% of individuals with diabetes. Approximately 20% of patients with diabetes are hospitalized because of foot problems.

  • Nerve Damage:
    • Neuropathy in your feet can cause serious complications. 
    • Diabetes can cause blood vessels to narrow and harden, resulting in poor blood flow in your feet, which means small wounds like those once trivial blisters, calluses, and cuts on your feet might become infected and may not heal well.
    • Chronic nerve damage can also cause dry and cracked skin on your feet which can allow bacteria to enter the foot and cause an infection.
  • Charcot’s foot:
    • While rare, nerve damage from diabetes can lead to changes in the shape of your feet.
      • Charcot’s foot can start with redness, swelling, and a feeling of warmth in your foot. 
      • It is a progressive condition that is characterized by the gradual weakening of your bones, joints, and soft tissues of your feet and/or ankles.
      • This can eventually lead to the bones in your feet and toes shifting or breaking, which can cause your feet to have an odd shape.

Complications from diabetes can lead to painful open sores on your feet that don’t heal. If an infection doesn’t get better with treatment, you may need to be hospitalized. Part of your toe, foot, or leg may need to be amputated to prevent the infection from spreading to other parts of your body.

How To Prevent Serious Diabetic Foot Problems

Seeing your foot and ankle surgeon regularly for periodic foot exams can help prevent complications that can be caused by diabetes.

Here are some other things you can do to prevent serious diabetic foot problems:

  • Check your feet every day — Check for cuts, blisters, swelling, redness, sores, corns, calluses, or any other change to the skin or nails. If you can’t see the bottom of your feet, ask someone for help! Or use a mirror if you prefer to perform the daily foot checks yourself. Call your doctor or podiatrist if you notice anything unusual.
  • Wash your feet every day — Wash in warm water — not hot! And don’t soak your feet for too long. Dry your feet thoroughly after washing.
  • Moisturize your feet — but don’t moisturize between your toes (we don’t want any fungal infections)! You don’t want your skin itching or cracking.
  • Never go barefoot — Ever. Even when you’re inside, make sure to wear shoes and socks or slippers. Before putting your shoes on, make sure the lining is smooth and there isn’t anything, like a small rock, that can cause irritation.
  • Cut your toenails carefully — trim your toenails straight across and smooth sharp edges with a nail file.
  • Get your feet checked! Your local podiatrist will be happy to examine your feet. They can help remove corns and calluses, and help trim your toenails. 
  • Don’t remove corns and calluses yourself — visit your podiatrist.
  • Wear clean, dry socks and change them daily.
  • Wear shoes that fit well. Always wear socks with your shoes. When breaking into your new shoes, do so slowly. 
  • Keep your feet warm and dry.
  • Don’t smoke — smoking restricts blood flow to your feet.
  • Get moving! Exercise is excellent for poor circulation as it stimulates blood flow in the legs and feet.
  • Diabetic shoes and insoles — your podiatrist may recommend you use diabetic shoes and/or inserts. These custom orthotics and/or shoes can help prevent ulcers, protect the anatomic integrity of your feet, and control the pressure of the foot.
Two tan slippers on a woman's feet on a tile floor

Why Choose a Podiatrist?

If you’re a diabetic, you can prevent serious foot complications by being mindful of your feet and your diabetes. It’s important to work with your diabetes care team to help manage your blood sugar, blood pressure, and cholesterol.  

Foot and ankle surgeons are the leading experts in foot and ankle care. They have extensive training as doctors of podiatric medicine (also known as podiatrists, foot and ankle doctors, or DPMs) and are board-certified surgical specialists with more education and training specific to the foot and ankle than any other healthcare professional. They deal with the prevention, diagnosis, and management of foot problems every day.

You can trust your podiatrist to treat any conditions that affect the foot or ankle, whether simple or complex. From custom orthotics to diabetic foot exams, to any surgery required because of diabetic foot complications, your foot and ankle doctor will be a valuable member of your diabetes care team.

All our podiatrists at Western Montana Foot and Ankle would be happy to help you on your diabetic care journey.

The Diabetes Epidemic

What is Diabetes?

November is diabetes awareness month, so what better time to learn about diabetes? Make sure you read our article that focuses more on diabetic foot care and the importance of working with a podiatrist if you currently suffer from diabetes.

The number of Americans living with diabetes is staggering. 1.4 million Americans are diagnosed with diabetes each year. If you think that’s alarming, consider the fact that 97 million American adults are living with prediabetes! With over 10% of the U.S. population living with diabetes, we are a nation hugely affected by this disease.

Diabetes mellitus refers to a group of diseases that affects how the body uses blood sugar or glucose. There are different causes and types of diabetes.

The Different Types of Diabetes:

  • Type 1 Diabetes
  • Type 2 Diabetes
  • Prediabetes
  • Gestational Diabetes

Insulin is a hormone that originates in the pancreas. The pancreas is a gland located behind and below the stomach. Insulin is released by the pancreas to lower the amount of sugar in the bloodstream. As your blood sugar level drops, so does the secretion of insulin from the pancreas.  

Glucose is a source of energy for the cells in our bodies that make up muscles and other tissues. It has two primary sources which are food and the liver. 

In all cases, regardless of the type of diabetes you have, sugar builds up in the bloodstream. High sugar levels are caused because the pancreas doesn’t produce enough insulin or the body cannot effectively use the insulin it produces. 

Two hands, testing blood sugar

Diabetes in the U.S. By the Numbers:

  • Over 38 million people have diabetes in the United States
  • Nearly 30 million people have been officially diagnosed with diabetes
  • 8.7 million people have diabetes and don’t even know it
  • Nearly 98 million US adults have prediabetes
  • According to the CDC, medical costs associated with diabetes were about $12,000 per person in 2022.
  • The estimated total cost of diagnosed diabetes in 2022 was $413 billion

Type 1 Diabetes

Type 1 diabetes can start at any age. However, it usually begins during childhood or in an individual’s teen years. It was once called juvenile diabetes. In this condition, the pancreas makes little to no insulin. In many cases, it’s the body’s own immune system that destroys the insulin-producing cells in the pancreas.

Type 1 diabetes is characterized by deficient insulin production and requires daily insulin administration. Even after years of research, no definitive cause or means of prevention has been discovered. Treatment focuses on managing the amount of sugar in the bloodstream using insulin injections, diet, and lifestyle to prevent complications.

Type 2 Diabetes

Type 2 diabetes is more common than type 1 diabetes, and it can develop at any age. More than 95% of people with diabetes have type 2 diabetes. It’s most common in people who are older than 40. However, research shows that the number of children developing type 2 diabetes is increasing.

Type 2 diabetes affects how your body uses sugar for energy. It prevents the body from using insulin properly, which can lead to consistently high levels of blood sugar if not treated.

Type 2 diabetes is often preventable. Some of the main factors that contribute to developing type 2 diabetes include being overweight, not getting enough exercise, and genetics. The earlier you can diagnosis type 2 diabetes the better. The best way to detect diabetes early is to get regular check-ups and blood tests.

Medications and blood sugar meter


Despite its name, prediabetes is a serious health condition. During prediabetes, blood sugar levels are higher than normal but not high enough to be diagnosed as type 2 diabetes. A staggering 98 million American adults — more than 1 in 3 — have prediabetes.

More than 80% of Americans who have prediabetes don’t know they have it. 

During prediabetes, your cells no longer respond as they should to insulin. As a result, your pancreas makes more insulin to try and get your cells to respond. Your pancreas is eventually unable to keep up, and your blood sugar levels rise.

You can have prediabetes for years and not experience any obvious symptoms. Prediabetes often goes undetected until more serious health problems arise. This is why it’s important to regularly check your blood sugar during checkups with your primary care physician.

Gestational Diabetes

Gestational diabetes is hyperglycemia with blood glucose values above normal but below those that indicate full-blown diabetes. Gestational diabetes occurs during pregnancy. It is diagnosed through prenatal screening.

Women with gestational diabetes are at an increased risk of complications during pregnancy and delivery. These women tend to have no symptoms of their gestational diabetes, which is why it is so important to have the proper tests during their pregnancy screenings.

Symptoms of Diabetes

Diabetes symptoms generally depend on how high your blood sugar levels are. For some people, symptoms are easy to spot. For others, it can take years for the disease to be noticed and diagnosed.

Symptoms of type 1 diabetes can be even less noticeable than symptoms of type 2 diabetes initially, and they tend to come on very suddenly. Symptoms of type 2 diabetes tend to come about more gradually.

Gestational diabetes usually goes away after the baby is born.

Some symptoms of type 1 and type 2 diabetes include:

  • Feeling tired and/or weak
  • Increased feelings of thirst 
  • Increased urination
  • Blurred vision
  • Slow-healing cuts and bruises
  • Increased frequency of infections.
  • Feeling irritable
  • Mood changes
  • Unexpected or unexplained weight loss
  • Ketones in urine 

Diabetes Complications

People with diabetes have an increased risk of other health problems, including stroke, heart attack, and kidney failure. Diabetes is known to cause many long-term health complications that can seriously affect your quality of life.

Many people with diabetes also develop problems with their feet from poor blood flow and nerve damage. In extreme cases, this can cause foot ulcers and may lead to amputation. 

  • Heart disease and blood vessel disease
    • Diabetes majorly increases the risk of many heart problems. These can include coronary artery disease, stroke, heart attack, and the narrowing of arteries.
  • Nerve damage from diabetes
    • “Diabetic neuropathy”
    • Too much sugar can injure the walls of the tiny blood vessels that nourish nerves, especially in extremities like your legs. This can cause tingling, numbness, burning, or pain that usually begins at the tips of the toes or fingers and gradually spreads upwards.
  • Kidney damage
  • Eye damage
    • Damaging the blood vessels of the eye can lead to blindness.
  • Foot damage
    • Nerve damage or poor blood flow to the feet can increase your risk of many foot complications.
  • Hearing problems
  • Skin and mouth conditions
    • Bacterial and fungal infections
  • Alzheimer’s disease
    • Type 2 diabetes may increase your risk of developing dementia.
orange juice, grapes, avocado, green grapes, toast, and an orange surrounding a bowl of oats with fruit and chia seeds on top.

Diabetes Prevention

While you can’t prevent type 1 diabetes, healthy lifestyle choices can help prevent and treat prediabetes and type 2 diabetes.

Here are some ways you can prevent diabetes in your life:

  • Healthy foods — Opt for foods that are lower in fat and calories and higher in fiber. Avoid sugars and saturated fats. Focus your diet around whole grains, vegetables, and fruits.
  • Activity — Stay active! 30 minutes of moderate exercise daily is a good goal. Daily walks are a great way to get some extra steps in. 
  • Lose excess weight — Reach and keep a healthy body weight by setting realistic fitness goals. If you’re overweight, losing just 7% of your body weight can lower the risk of diabetes.  
  • Do not smoke tobacco

Long-term changes to your eating and exercise habits play a large role in preventing and managing diabetes.

Each diabetes journey is unique. It’s important to monitor your diabetes closely and have a team of medical professionals to help guide you and advise on what changes you can make to manage your diabetes best.