Diabetes & Feet in a Post Covid-19 Environment

Dr. Pamela Karman is a NYC podiatrist practicing for over 35 years. She is a Diplomate of AAMFS and certified by The American Board of Foot Surgeons. She is in private practice on Manhattan’s Upper East Side and is a Distinguished Member of The NYS Board of Podiatry (a division of The NYS Board of Regents).

For many years, I have been working in the field of podiatric medicine and surgery, I have noticed that the incidence of Type 2 Diabetes has continually risen.

Clearly, we know it is mandatory that the patient maintain cleanliness and observe any changes in skin tone, nerve sensation, and nail pathology. Upon observation of problematic issues, the foot specialist should be seen.

We encourage all patients to come in to see their foot-care specialist for routine nail debridement, trimming of calluses, and evaluation of blood perfusion to the feet and ankles. We evaluate swelling, gait abnormalities, neuropathies, and changes in skin turgor as well as changes in the nails of the feet.

The feet, however, are only part of the potential problems common to patients in a post Covid-19 world.

Unfortunately, many patients have become more sedentary, depressed, eat more comfort foods, and as a result of this, gained weight. Podiatrists know that if you gain 5 pounds, that causes an extra 15 pounds on each foot with every step you take while walking and 25 pounds per foot with every step when running. This additional torque of forces on the foot will have a deleterious effect on knees, hips, back, etc. Excess weight gain contributes to obesity- a major dilemma in today’s world and co-morbidities such as cardiovascular disease.

Therefore, the old dictum, “you are what you eat”. becomes very crucial in glycemic control. If a diabetic does not control blood sugar - which is done with diet, exercise, and if needed, medication, the hemoglobin A1C (an average of a patient’s blood glucose level monitored to ensure glycemic control) will become elevated and it could, without control, become deadly. Uncontrolled blood sugar leads to poor wound healing, vascular compromise, inability to fight infections, neuropathies, vision loss, loss of limb, and on and on.

It is for this reason that the diabetic patient must consider a low carbohydrate diet. Healthy eating will yield positive results for a patient in a matter of weeks. Often, with regular exercise and proper nutrition, medications may be lessened or alleviated.

A low carb diet will lower blood sugar, lessen obesity, and decrease the risk of cardiovascular compromise. It will increase the good cholesterol (HDL) and facilitate the decrease of bad cholesterol (LDL), in addition to lowering blood pressure and glycemic control.

Well-controlled blood sugar equates to markedly lower mortality and better quality of life. A low carb, Mediterranean Diet is the key to controlling high blood sugar, obesity, and cardiovascular issues.

These changes, in conjunction with routine examinations and pedal prophylaxis, will have beneficial results for not only diabetic patients but all patients.

Dr. Pamela Karman is available for consultations and evaluations at her office located at 19 East 80^th Street Suite 1E New York, N.Y. 10075 at (212) 570-5442. She is rated as one of the top female podiatrists in New York.