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Dr. Tom Biernacki, DPM, FACFAS

Dr. Tom Biernacki is a double board-certified podiatric foot and ankle surgeon practising in Michigan. He treats diabetic wounds, Charcot neuroarthropathy and at-risk feet daily, and writes here to put the clinical reasoning behind that care in front of the people living with it.

Diabetic Foot Care Products

September 7, 2026 by Dr. Tom Biernacki, DPM, FACFAS
Diabetic Foot Guide article card: Diabetic foot care products, in the Prevention series, by Dr. Tom Biernacki, DPM, FACFAS

Six things do almost all the work, three sold for diabetic feet should never touch one, and the most useful item in the kit costs about five dollars.

Categories Prevention

Swollen Feet and Diabetes

September 7, 2026 by Dr. Tom Biernacki, DPM, FACFAS
Diabetic Foot Guide article card: Swollen feet and diabetes, in the Conditions series, by Dr. Tom Biernacki, DPM, FACFAS

Both feet swelling usually points somewhere systemic. One foot, warm and red on a neuropathic foot, is Charcot until proven otherwise. Where the line sits.

Categories Conditions

Brown Spots on Feet and Diabetes

September 7, 2026 by Dr. Tom Biernacki, DPM, FACFAS
Diabetic Foot Guide article card: Brown spots on feet, in the Conditions series, by Dr. Tom Biernacki, DPM, FACFAS

Diabetic dermopathy is harmless and needs no treatment, but it travels with the other complications. How to tell shin spots from venous staining and from the rest.

Categories Conditions

Gangrene in the Diabetic Foot

September 7, 2026 by Dr. Tom Biernacki, DPM, FACFAS
Diabetic Foot Guide article card: Gangrene in the diabetic foot, in the Wound care series, by Dr. Tom Biernacki, DPM, FACFAS

Dry, wet and gas gangrene look different and move at different speeds. How they are told apart, why it often does not hurt, and which one is measured in hours.

Categories Wound Care

Dry and Cracked Feet in Diabetes

September 7, 2026 by Dr. Tom Biernacki, DPM, FACFAS
Diabetic Foot Guide article card: Dry and cracked feet, in the Conditions series, by Dr. Tom Biernacki, DPM, FACFAS

Dry skin in diabetes is a neuropathy sign, not neglect. Why heels crack, what urea actually does, and why a pumice stone is the wrong tool on a numb foot.

Categories Conditions

Diabetic Toenails: Care and Risks

September 7, 2026 by Dr. Tom Biernacki, DPM, FACFAS
Diabetic Foot Guide article card: Diabetic toenails, in the Prevention series, by Dr. Tom Biernacki, DPM, FACFAS

A thick toenail presses on the tissue underneath on a toe that cannot feel it. Fungal nails, ingrowing edges, and when nail care should stop being a home job.

Categories Prevention

Diabetic Foot Cream: What Works

September 7, 2026 by Dr. Tom Biernacki, DPM, FACFAS
Diabetic Foot Guide article card: Diabetic foot cream, in the Prevention series, by Dr. Tom Biernacki, DPM, FACFAS

Urea concentration is the whole decision, and salicylic acid corn removers cause ulcers. What to look for on the label, and the rule about between the toes.

Categories Prevention

Rash on Feet From Diabetes

September 7, 2026 by Dr. Tom Biernacki, DPM, FACFAS
Diabetic Foot Guide article card: Rashes on diabetic feet, in the Conditions series, by Dr. Tom Biernacki, DPM, FACFAS

Fungal infection, dry skin from lost sweating, diabetic dermopathy or poor circulation. Which pattern is which, and the one that needs seeing the same day.

Categories Conditions

Non-Diabetic Foot Ulcers Explained

September 7, 2026 by Dr. Tom Biernacki, DPM, FACFAS
Diabetic Foot Guide article card: Non-diabetic foot ulcers, in the Wound care series, by Dr. Tom Biernacki, DPM, FACFAS

Neuropathic, venous, arterial and pressure ulcers look different and need opposite treatments. How to tell them apart, and why compression can harm the wrong one.

Categories Wound Care

Diabetic Foot Infection: Signs

September 7, 2026 by Dr. Tom Biernacki, DPM, FACFAS
Diabetic Foot Guide article card: Diabetic foot infection, in the Wound care series, by Dr. Tom Biernacki, DPM, FACFAS

Infection is diagnosed by looking at the foot, not by swabbing it. The signs, why fever is often absent, and the probe-to-bone test that changes the whole plan.

Categories Wound Care
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Who writes this

Dr. Tom Biernacki, DPM, FACFAS is a double board-certified podiatric foot and ankle surgeon in Michigan. Diabetic wounds, Charcot neuroarthropathy and at-risk feet are daily work, not a side interest.

About this site · Editorial policy

Start here

  • What diabetes does to feet
  • Charcot foot
  • Diabetic foot ulcers
  • The diabetic foot exam
  • Diabetic shoes and Medicare

Be seen today if

Fever, redness spreading up the leg, pus or a bad smell, black tissue, or a foot that has turned cold, pale or dusky. An open wound on a diabetic foot is a this-week problem even when it does not hurt.

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