Diabetes damages feet quietly. The nerve that would make you limp goes first, so the wound, the infection and the collapse all arrive without pain to announce them. This site explains what is actually happening, written by a foot and ankle surgeon who treats it.
If you are here because something is wrong right now
One foot hot, red and swollen with no wound? That is Charcot foot until proven otherwise, and it is a matter of days.
An open sore, however small or painless? Read diabetic foot ulcers and get seen this week.
Fever, spreading redness, pus, black tissue, or a cold dusky foot? That is an emergency department today, not an appointment.
Start here
What diabetes does to feet
Five systems fail differently — nerves, arteries, skin, bone, immune response — and every foot problem that follows is a combination of them. The place to start if nothing is wrong yet.
Charcot foot
The bones soften, the arch collapses in weeks, and it is misdiagnosed in roughly two thirds of cases. Stages, the temperature test, and why the cast takes months.
Diabetic foot ulcers
Offloading is the treatment; dressings are support. Grading, the circulation question, and what a wound still open at six weeks is telling you.
The diabetic foot exam
What a proper examination includes, what the 10-gram monofilament tests, and why a normal ankle-brachial index can lie in a diabetic foot.
Why this site exists
Search for almost any diabetic foot problem and the results are either a hospital page written to be unimpeachable rather than useful, or a practice page written to rank. Both leave out the part that decides outcomes: the reasoning. Why offloading beats dressings. Why a normal X-ray does not exclude Charcot. Why the certifying physician for Medicare diabetic shoes cannot be your podiatrist. Why a wound that has not closed in six weeks needs a different question, not more patience.
That reasoning is what a foot and ankle surgeon uses every day and it is almost entirely absent online. This site is an attempt to put it in front of the people it belongs to.
The daily foot check, in thirty seconds
- Both feet, every day, in good light — soles included, using a mirror or a phone camera if you cannot see them.
- Between every pair of toes. Damp, white, split skin there is where infection starts.
- Anything new: redness, a blister, a crack, a dark spot inside a callus, drainage on a sock.
- Compare the two feet for warmth with the backs of your hands. One foot noticeably hotter is a finding.
- Shake out and hand-check the inside of every shoe before you put it on.
The rule that prevents most of it
Nothing sharp, no corn plasters, no callus removers, no bathroom surgery, and never barefoot — indoors included. Most injuries to an insensate foot happen at home, to people being sensible about everything else.
In Michigan?
Balance Foot & Ankle sees diabetic wounds, Charcot, at-risk foot exams and therapeutic footwear in Howell and Bloomfield Hills.