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Have diabetes and gout. Sores on the toes. What kind of foot specialist should I see?

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Hi i have sores on the sides of my toes for about ayear now in the past these areas have had gout i am a diabetic and circulation to right leg is 60-70% the 2 areas of infection regulary heal to a very small eruptive area in centre of infected area . what do you suggest or what type of foot specialist should i see or what medical remedies may i try thankyou XXXXXXX
Posted Sun, 24 Jun 2012 in Diabetes
Answered by Dr. Amit Rajput 2 hours later

Thank you for posting on XXXXXXX

The problem you are facing is very common in people with long standing diabetes. The cause of these kind of sores are:

1) inadequate blood supply
2) Neuropathy
3) inadequate control of blood glucose
4) abnormal foot pressures due to neuropathy

From the above four factors, first one is something which cannot be altered practically. So lets concentrate on the other three factors, which could help your sore heal faster.

Neuropathy - This can be reversed to an extent by tight glucose control with oral medicines or/and insulin. If the glucose control is bad, neuropathy worsens.

Glucose control - You should XXXXXXX your diabetologist/endocrinologist/physician and discuss about blood glucose control, preferably with insulin, which promotes healing.

Abnormal foot pressures - Pressures on the feet is altered in long standing diabetics. The sores usually develop over the high pressure areas. These sores wouldn't heal unless the pressure on them is removed (offloading). This can be very effectively done by proper footwear specially designed for this purpose.

To conclude - You need to consult a good physician who can look after your blood sugars, if deranged, preferably with insulin. You also would want to consult a podiatrist (or a foot surgeon), who can prescribe you an appropriate customized footwear so that the sores heal fast.

Hope I have answered your query. I will be available to answer your follow up queries, if any.

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