Are you having back pain with any of the following?
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
Diabetes is a condition that makes it difficult for your body to regulate blood sugar levels. Managing diabetes means adopting healthy behaviors and taking medication as directed to stay healthy and prevent complications.
People with diabetes can experience a wide variety of foot problems that include skin ulcers, numbness, and muscle weakness. Foot problems are common in people with diabetes; however, most are preventable.
Diabetes can cause foot problems in two ways:
Keeping your blood sugar in your target range will reduce your chance of developing circulation problems and damage to the nerves. We can help you learn how to take care of your feet.
Symptoms of diabetic foot problems often fall into two categories: those caused by poor circulation and those caused by nerve damage. Some of the most common symptoms include
Symptoms of poor circulation:
Symptoms of nerve damage in the feet and legs:
Contact us immediately if:
We diagnose your foot problem by talking to you about your symptoms, evaluating your diabetes and other medical history, and physically examining your feet. We may also order X-rays to look at the bones or soft tissue in your feet.
We will ask you a number of questions about your symptoms and medical history:
We will examine your foot and perform a number of tests that include
Tests for nerve function.
Tests for circulation damage. We will check:
We will examine your feet for sores, corns, or calluses by checking for:
If we do find a sore, we will examine it closely to check for:
You are at greater risk of developing foot problems if you have poor circulation and/or nerve damage caused by diabetes.
Poor circulation caused by hardening of the arteries can lead to a number of problems that include:
Nerve damage can occur due to high blood sugar levels. This can increase your risk of developing a number of foot problems that include loss of feeling in areas of your foot, dry skin, and weak foot muscles:
Loss of feeling
Weak foot muscles
Proper foot care includes checking your feet every day, keeping your feet clean and dry, and choosing and wearing supportive and well-fitting shoes and socks. In addition, you can prevent most diabetic foot problems by keeping your blood sugar under control and taking good care of your feet. When you have diabetes, we recommend monitoring your blood sugar with a glucose meter.
Monitoring your blood sugar
A glucose meter is a small device (smaller than a cell phone) that quickly reads your blood sugar levels and saves the reading for future reference. Meters are easy to use and to carry with you. You can check your blood sugar at home, at work, or anywhere.
Monitoring tells you if your blood sugar is in your target range, or if it is too low or too high. With this information, you can decide what action to take.
Low blood sugar (hypoglycemia). Blood sugar less than 70 mg/dL is too low for most people who take diabetes pills or insulin. If you take certain diabetes pills (sulfonylureas or alpha-glucosidase inhibitors) or insulin, it's important to know the symptoms of low blood sugar, how to treat low blood sugar, and how to prevent it.
Low blood sugar can develop because of:
High blood sugar (hyperglycemia). This can develop because of:
Monitoring also tells you how your blood sugar is affected by:
Blood sugar targets
When you monitor your own blood sugar, it is important to know your blood sugar targets. Talk with us about your personal targets. For many people, the blood sugar targets are:
|Before a meal||70 - 130|
|2 hours after a meal||Less than 180|
|Bedtime||100 - 140|
Taking care of your feet daily helps prevent infections and injuries. By checking your feet daily, you are more likely to notice problems early so we can start treatment right away.
Check your feet every day
Look at your feet each day for redness, blisters, swelling, pus, sores or cuts that are not healing, cracks, and ingrown toenails. Use a mirror or ask someone else to help you if you cannot see your whole foot. Press down on the skin to check for swelling and compare each foot with the other foot. Pay close attention to:
Prevent injury and infection
Any opening in the skin can increase your risk of developing an infection. As a result it is important to be very careful with your feet. There are a number of things that you should not do when caring for your feet because they can lead to breaks in the skin and infection:
Follow a daily foot hygiene routine
Choose the right shoes
Healthy feet need comfortable, supportive, and breathable footwear to stay that way. Here are some tips for buying and wearing your shoes:
We may recommend custom shoes with custom insoles if you already have joint changes or other foot problems. If this is the case, please follow these guidelines for wearing custom shoes:
It's also important to keep your feet clean, dry, and protected.
Not too hot, not too cold
If you have lost feeling in your feet, you can easily injure them by exposing them to water or surfaces that are either too hot or too cold. Here are some steps you can take to prevent this from happening:
Treatments for mild skin infections and foot sores
We treat foot sores in a number of ways, depending on their location and severity. Common treatments include:
Treatments for severe diabetic foot problems
If your foot problems are severe, we may need to bring you in to the hospital to treat you. More complex treatments include the following:
The most important thing you can do to keep your feet healthy is to keep your blood sugar levels under tight control, treat any high blood pressure, and if you smoke, stop.
Quitting tobacco is one of the most important steps you can take to improve your health. We have many resources to help you quit. Stopping smoking lowers your risk of developing serious diabetes-related health problems such as heart disease and nerve damage. Treating high blood pressure can prevent damage to your arteries that can contribute to foot problems.
We have a range of resources to help you manage your diabetes, control your blood pressure, and assist you with lifestyle changes and management.
If you have diabetes, your personal physician will monitor your feet as part of your regular diabetes care.
If specialty care is needed, your personal physician will facilitate the process of scheduling an appointment in my department. If appropriate, she or he might call me or one of my colleagues while you are in the office so we can all discuss your care together. If we decide you need an appointment with me after that discussion, we can often schedule it the same day or soon thereafter.
During your office visit, we will discuss your medical and family history and I will examine your feet. I will explain the findings of your exam and answer any questions or concerns you may have. We will discuss treatment options, and together we will create a treatment plan that is right for you.
If you need to talk with me after your visit or procedure, please call my office. You can also e-mail me with nonurgent issues from this website whenever it is convenient for you.
If you have urgent concerns or issues while my office is closed, or need general medical advice, you can call the Appointment and Advice line, available 24 hours a day, 7 days a week. You will be connected with a nurse who can give you immediate advice.
If you are experiencing a serious problem or an emergency, call 911 or go to the nearest Emergency Room when the clinic is not open.
As your specialist, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.
My Doctor Online is available at any time that is most convenient for you. From my home page you can:
Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.
Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay connected on your health status and collaborate with each other as appropriate.
When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.
We will work together to monitor and assess how your medications are working and make adjustments over time. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.If refills are needed in the future, you can:
For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, we will schedule an appointment with the radiology department. When the results are ready, I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.
If we decide together that your condition would also benefit from the care of other types of specialists, our staff will help arrange the appointment(s) with one or more of my specialty colleagues.
I will recommend you review educational information and tools to help you prepare for your procedure or surgery. The information will often help you decide whether surgery is right for you. If you decide to have a surgery or procedure, the information will provide details about how to prepare and what to expect.
If we proceed with surgery, I will have my Surgery Scheduler contact you to determine a surgery date and provide you with additional instructions regarding your procedure. Once your surgery is scheduled, a medical colleague of mine will contact you to conduct a preoperative medical evaluation that will assure that you are properly prepared for your surgery.
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.