want to

learn more


what diabetics need to know
about their foot health

Diabetes affects the feet in really two different ways. The first way, and the way that most people associate with diabetes is circulation. They think, “If I have diabetes, my circulation is going to get bad, and that’s going to cause me to have foot problems.” That’s true in some people, but in most people that’s really not the case. The majority of people with diabetes have problems with their feet because of neuropathy, which is numbness or tingling or burning or an electrical sensation. The numbness is the thing that causes difficulties.

What the usually scenario is for a patient with diabetes that we see who gets in trouble with their feet is, first of all, they’ve had diabetes for quite a few years – maybe ten years. Sometimes they haven’t been very good at controlling their blood sugar, so this causes some toxicity to develop in the nerves and they don’t feel their feet very well. There’s also damage to their circulation o some degree. Subsequently they get a callus on their foot from either a pressure point or a deformity, and they end up with a callus that forms pretty thickly, and underneath that it starts to bleed a little bit. The skin gets compromised and it breaks down – which is a diabetic foot ulcer. All of that can be avoided using three techniques.

The first thing is inspection.

What that means is that every day, if you have diabetes, you should take a really close look at your feet. Now, if you can’t see your feet, you should get some help, or you can get a mirror to look at your feet. Look between your toes, on the outside of your foot, which is tough to see for most of us, the bottom of your foot – any place that you see a callus or something, you should probably start paying attention to that and get some help. The next time you see your doctor, ask him about your feet.

The second thing is protection.

Make sure you wear good shoes. I remember an experience when I was in LA county hospital – we had a patient come in for a regular diabetic foot check, who had a little toy in his shoe. That gentleman was so numb that he couldn’t feel the toy in his shoe. He subsequently lost his leg due to not being able to feel his foot. So, protection involves wearing a good shoe, looking at your shoes before you put them on, and wearing a sock that’s soft. Make sure your shoes fit well and never depend upon how the shoe feels. You have to measure the shoe, or even better, get an x-ray of your foot taken while wearing your shoes to make sure they fit well and aren’t altering your feet.

The third thing to do is intervention.

If you see any kind of a callus – especially one with some bleeding or discoloration, get to your doctor as soon as possible (preferably be a podiatrist, because they are often better equipped to handle these types of situations than family doctors). You’ll need to get the pressure off that area as soon as possible. If you need to, you may have to wear a special shoe or boot to get that to heal.

If you can prevent a foot wound by doing inspection, protection, and intervention, you’re going to be miles ahead and avoid many of the difficulties of diabetes and your feet.”

What do Diabetics Need to Know about Foot Health?

minimially invasive

treatment & surgery

for diabetic foot conditions


treatment & surgery options

Dr. Silvester and Dr. Larsen specialize in many advanced minimally and non-invasive treatments, and if necessaryadvanced minimally invasive and traditional surgical techniques with patient proven success stories.

Some of those are used to treat your diabetic foot conditions, such as:

Learn More >

EpiFix is a dehydrated amnion/chorion membrane allograft (skin substitute product) that contains growth factors essential for wound healing. EpiFix when applied to an open wound will help your own cells regenerate the damaged tissue, reduce scar tissue formation, and control inflammation.

Proven Clinic Healing!

EpiFix Treatments demonstrates clinical superiority in the management of diabetic foot ulcers in multiple prospective, randomized comparative studies.

Learn More >

Treat diabetic foot wounds AT THE SOURCE!


Diabetic Foot Ulcer
before & after treatment

Slide the arrows left and right to see the incredible before and after success images of this patients chronic diabetic wound that he was unable to heal on his own. 

This wonderful patient of ours came to us with a Diabetic wound he was unable to heal on his own. After working closely with Dr. Silvester, trusting the process, his treatment plan and eventually needing surgery to treat the problem at it’s source with Achilles Tendon Lengthening, A.D. (our patient) was able to finally heal his wound.

Dr. Silvester talks about what Diabetics need to know about foot health.

Click the chat icon to request a appointment call back request, or call us at 210-375-3318.

What Our Patients
Say About Us

Take the next step
to happy feet!

Click the links to request your appointment or learn more about what Next Step Foot & Ankle Clinic can do for you.

Where will take you?