Prevention and early detection and treatment of foot sores are crucial to avoid amputations

By William K. Alcorn


One of the biggest fears diabetics have is amputation. Patient education about the importance of early detection of sores on their feet and ankles, improved treatments and medications and techniques to improve circulation and treatment of neuropathy are helping diabetics avoid amputations and other effects of the disease.

Nonetheless, according to the American Diabetes Association more than 60 percent of all non-traumatic lower-leg amputations worldwide are related to complications from the disease.

Diabetes afflicts more than 30 million Americans, according to the American Podiatric Medical Association, which reported that more than 65,000 lower limbs are amputated annually due to complications from diabetes.

Despite the statistics, there are ways to avoid most amputations.

“To me, the most important thing in preventing amputations is early detection of ulcers or wounds, particularly on the feet. Diabetics should check their feet on a daily basis,” said Dr. John Chiaro Jr., one of the podiatrists at Ankle & Foot Care Centers which has several offices in the area.

“My main point is early detection and prevention. That is what we’re all about,” said Dr. Chiaro, who completed his undergraduate work at Youngstown State University where he was a recipient of the YSU Foundation and the Dave Pavlansky Memorial scholarships.

He graduated from Ohio College of Podiatric Medicine in Cleveland and did post-graduate work and his residency at Youngstown Osteopathic Hospital.

November was National Diabetes Month, the purpose of which is to spread awareness of and discuss the important link between proper foot care, diabetes, foot ulcers and amputations.

“If you have diabetes or are at risk for the disease, it is important to check your feet daily and schedule checkups by a podiatrist at least twice a year to prevent serious complications,” said Dr. Chiaro.

A comprehensive foot care treatment plan, including risk assessment, foot care education, preventative therapy, treatment of foot problems, as well as referral to specialists, can reduce amputation rates by as much as 85 percent, say the U.S. Centers for Disease Control and Prevention.

Podiatrists are medically trained to treat foot conditions that result from diabetes, such as neuropathy, infection and diabetic ulcers.

A diabetic ulcer is an open sore or wound that most commonly occurs on the bottom of the foot. Ulcers surface in about 15 percent of patients with diabetes. Of those who develop a foot ulcer, 6 percent will be hospitalized due to infection or other ulcer-related complication.

“Once an ulcer is noticed, patients with diabetes should be treated quickly in order to reduce the risk of infection and amputation. Treatment can also improve function and quality of life and reduce the likelihood of expensive medical care in the future,” said Dr. Chiaro, a member of the Ankle & Foot Care Centers group since 2000.

“Foot ulcers in peripheral neuropathy, characterized by a loss of feeling in the feet, can also lead to complications. Podiatrists can treat this condition, in some patients, by decompressing the patient’s nerves to restore feeling and function, said Dr. Chairo, who is board certified by the American Board of Podiatric Surgery.

While there are some vitamins and some pharmaceutical solutions that help, peripheral neuropathy is difficult because it progresses to loss of sensation which leads to potential wounds on the foot which can result in infection.

“It is our job to prevent that,” said Dr. Chairo of Poland, who is married and has two children.

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