By practicing prevention, Vernon Woodson, a diabetic for 12 years, has successfully avoided serious foot care challenges.

“Diabetics are prone to having foot problems such as wounds, foreign bodies, deformities (e.g., bunions), and infections. They may not even know it, because over time they (diabetics) all will develop neuropathy to some degree,” said Charles J. Hastings, DPM, FACFAS, owner and physician at McKenzie-Hastings Institute for Foot & Ankle Surgery. “Neuropathy of the lower extremities typically plays a major role in the diabetic complications we see.”

“One theory on how diabetics get neuropathy is from chronically high sugar levels and resultant nerve swelling. Through osmosis, elevated sugar levels cause nerves to swell. Sometimes the nerves swell so severely that they essentially choke off the smallest blood vessels that feed the smallest nerves,” said Dr. Hastings.

“Persons suffering from an advanced form of neuropathy cannot let pain be their guide. Diabetics with untreated wounds or infections may result in loss of toes, feet, legs or worse. In patients with neuropathy, surgery sometimes can be performed without the need for anesthesia,” Dr. Hastings said.

“If you cannot feel me doing surgery on you, how would you be able to feel something simple like a splinter or ingrown toenail? You won’t until the symptoms are further up your leg to where you have a little more feeling, and then you seek help. By then it may be too late,” he added.

Practicing preventive foot care techniques used by Mr. Woodson and other diabetics, such as conducting daily foot inspections, is essential for diabetes.

Other preventive and disease management methods involve “making smart food decisions and continue doing activities you love. I don’t like to tell my patients to ‘diet and exercise’, because many patients have no idea what that means.

“Diabetics are apt to have foot problems; therefore, a foot care specialist should be part of each patient’s healthcare team,” said Dr. David Lieb, Eastern Virginia Medical School Strelitz Diabetes Center of Western Tidewater Medical Director. The Diabetes Center at Sentara Obici Hospital is funded by the Obici Healthcare Foundation.

The Diabetes Center offers vouchers to its  uninsured patients in need of diabetic foot care examinations or treatment. Referrals are made  to the McKenzie-Hastings Institute for Foot &  Ankle Surgery.


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