Diabetic Foot Care

At a glance: Dr. Patish holds board certification in Prevention and Treatment of Diabetic Foot Wounds and Limb Preservation and Salvage from the ABMSP. Our diabetic foot care program includes annual comprehensive exams, neuropathy screening, therapeutic footwear fitting, custom orthotics, wound prevention strategies, and coordination with your primary care physician — all aimed at keeping you on your feet.

Diabetic Foot Care — Why Your Feet Need Specialized Attention

Diabetes affects your feet in two critical ways: it damages nerves (neuropathy) and reduces blood flow (peripheral vascular disease). Together, these changes mean a small blister, cut, or pressure point can become a serious wound — sometimes without you even feeling it. Roughly 15% of people with diabetes will develop a foot ulcer at some point, and foot complications remain the leading cause of non-traumatic lower-limb amputations in the United States.

The good news: the vast majority of these complications are preventable with routine podiatric care, proper footwear, and patient education. That's exactly what our program is designed to do.

Our Comprehensive Diabetic Foot Exam

Every diabetic foot visit at Fallbrook Podiatry includes a systematic evaluation designed to detect problems before they become emergencies.

Neurological Assessment

We test protective sensation using Semmes-Weinstein monofilament testing at multiple plantar sites. Loss of sensation at the 5.07/10-gram monofilament level is the established clinical threshold for neuropathy risk. We also assess vibration perception, reflexes, and proprioception to map the extent of nerve involvement.

Vascular Assessment

We evaluate pedal pulses (dorsalis pedis and posterior tibial), skin temperature, capillary refill time, and the overall condition of the skin and nails. Patients with diminished pulses or signs of ischemia may be referred for formal vascular studies.

Dermatologic and Structural Assessment

We inspect the entire foot for calluses, corns, fissures, fungal infections, ingrown nails, and any areas of abnormal pressure or skin breakdown. Structural deformities — hammertoes, bunions, Charcot changes, prominent metatarsal heads — are documented and addressed as risk factors for ulceration.

Footwear Evaluation

We examine your shoes for abnormal wear patterns, inadequate support, and pressure points. Many diabetic foot problems begin with ill-fitting footwear. We'll recommend modifications or therapeutic shoes as indicated.

Neuropathy Management — Treating Nerve Pain and Protecting Sensation

Peripheral neuropathy is the most common complication of diabetes, affecting up to 50% of patients over time. It typically begins in the toes and feet and progresses proximally. While the nerve damage itself is difficult to reverse, we can significantly improve your comfort and reduce your risk.

Treatment Options for Diabetic Neuropathy

• Blood sugar optimization: The single most important factor. We coordinate with your PCP or endocrinologist to ensure your A1c targets are being met.
• Laser therapy: Our Summit Series dual-frequency laser (810nm + 980nm) reduces neuropathic pain and promotes microvascular circulation in the feet.
• H-Wave therapy: Non-invasive electrical stimulation that improves local blood flow and reduces pain. Particularly effective for the burning, tingling sensations of neuropathy.
• Custom orthotics: Redistribute pressure away from vulnerable areas, accommodating deformities and reducing shear forces that lead to ulceration.
• Therapeutic footwear: Depth shoes with custom molded inserts — covered annually under the Medicare Therapeutic Shoe Bill for qualifying patients.
• Nutritional support: Targeted supplementation (B-complex vitamins, alpha-lipoic acid) to support nerve health, guided by your clinical picture.

Wound Prevention — The Core of Diabetic Foot Care

Prevention is always better than treatment. Our wound prevention strategy addresses every modifiable risk factor.

Routine Nail and Callus Care

For patients with neuropathy or vascular compromise, even routine nail trimming carries risk. We provide safe, medical-grade debridement of thickened nails, calluses, and corns on a regular schedule — typically every 8–12 weeks. This is covered by Medicare and most insurance for qualifying diabetic patients.

Patient Education

We teach you a daily self-inspection routine — what to look for, when to call, and how to protect your feet between visits. Simple habits like checking your feet every evening, never walking barefoot, testing bath water with your elbow (not your toes), and moisturizing dry skin can prevent the majority of diabetic foot emergencies.

Risk Stratification

Not every diabetic patient carries the same risk. We categorize your individual risk level — from low (intact sensation, good circulation) to high (prior ulcer, neuropathy plus deformity) — and set a visit schedule accordingly. Higher-risk patients benefit from more frequent monitoring.

When Wounds Do Occur

Despite best efforts, wounds can happen. Dr. Patish is board-certified by the ABMSP in Prevention and Treatment of Diabetic Foot Wounds and Limb Preservation and Salvage — credentials that reflect advanced training specifically in saving limbs and managing complex diabetic foot wounds.

Our wound management approach includes thorough debridement, offloading with specialized boots or casting, advanced wound care products, infection management, and close monitoring until full closure. We coordinate with vascular surgery, infectious disease, and endocrinology as needed.

Charcot Foot — A Hidden Danger

Charcot neuroarthropathy is a serious complication where neuropathy leads to progressive joint destruction and deformity — sometimes mistaken for an infection or sprain. Early detection is critical. If you notice sudden redness, warmth, or swelling in one foot without an obvious injury, contact us immediately. Prompt immobilization can prevent permanent structural collapse.

Your Diabetic Foot Care Checklist

• Inspect your feet daily — top, bottom, between toes.
• Wash feet with lukewarm water; dry thoroughly, especially between toes.
• Apply moisturizer to prevent cracking — but not between toes.
• Never go barefoot, even indoors.
• Wear properly fitted shoes with seamless interiors.
• Check inside shoes before wearing — small objects can cause wounds you don't feel.
• Keep toenails trimmed straight across — or let us handle it.
• Report any changes immediately: color, temperature, new calluses, open areas.

For more detailed guidance, see the MedlinePlus: Diabetic Foot resource from the National Institutes of Health.

Board Certification That Matters

Dr. Patish holds three active board certifications from the American Board of Multiple Specialties in Podiatry (ABMSP): Primary Care in Podiatric Medicine, Prevention and Treatment of Diabetic Foot Wounds, and Limb Preservation and Salvage. This combination of credentials means your diabetic foot care is managed by a podiatrist with verified, advanced-level training in exactly the complications you need to prevent. Learn more about Dr. Patish's credentials.

Schedule Your Diabetic Foot Exam

Whether you're newly diagnosed or have been managing diabetes for years, a comprehensive foot exam is one of the most important preventive steps you can take. Call or text (760) 728-4800 to schedule your evaluation at our Fallbrook or Temecula office. Bring your most recent A1c result and your everyday shoes — we'll take it from there.