Knowledgeable Aging

Resources for the Aging Population

Diabetes and Feet

Talking Points:

  1. Chronically elevated blood sugars cause vascular disease called small vessel disease or Peripheral Vascular Disease- PAD
  2. Small vessel disease causes nerve malfunction in the feet
  3. Nerve malfunction causes loss of protective sensation for pain (LOPS), foot deformities and changes to the skin causing fissures cracks and dryness
  4. LOPS sets the stage for painless trauma of Mechanical, Chemical, or Thermal origin
  5. Traumas are the triggering events that lead to foot ulcers
  6. If foot ulcers are not detected and treated promptly, soft infections can set in that lead to bone infections
  7. Infections need to be treated with antibiotics and adjunct therapies
  8. If these therapies fail to alleviate the infection, surgery will be necessary to excise the infected tissue and may necessitate amputation of a part of the foot or leg
  9. Preventing the foot ulcer and infection, prevents hospitalization and amputation

Listen to the Podcast

  • 2:38 – Your feet must last a lifetime
  • 4:42 – Diabetes: Foot health statistics
  • 6:11 – Conditions leading to amputation
  • 8:40 – Diabetic Neuropathy and Ischemia (Semmes-Weinstein Monofilament)
  • 12:16 – Guidelines for Peripheral Arterial Disease Testing
  • 13:48 – Risks factors for diabetic foot ulcers
  • 14:12 – Diagnoses that increase risk for amputation
  • 15:16 – Ulcer avoidance and patient feelings
  • 16:07 – Preventing foot ulcer and amputation
  • 18:30 – Future of amputation prevention (personalized medicine, machine learning and AI)
  • 21:36 – Questions
Dr. Mark Hinkes

Dr. Mark Hinkes is a Doctor of Podiatric Medicine who recently retired from clinical care after 40 years’ service. 20 years in private practice in Miami, FL and 20 years at the Veterans Affairs Medical Centers. In Nashville, Tennessee he served as the Chief of Podiatry Services and Director of Podiatric Medical Education. He has been the Chairman of the Preservation Amputation Care and Treatment (PACT) Program for over a decade.

Dr. Hinkes is certified by the American Board of Foot and Ankle Surgery and the American Professional Wound Care Association. He is a diplomat of the American College of Foot & Ankle Surgeons. His professional memberships include the American Podiatric Medical Association, American Podiatric Writers Association, American Professional Wound Care Association and Association for the Advancement of Wound Care. He is a frequent blog contributor to several wound care blogs including Podiatry Today Magazine and his personal LinkedIn site. He is President and CMO of ePrevenir, a company who offers a cloud-based tool for Primary Care Providers to manage the four comorbidities of diabetes.

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