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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Abnormal Ulcers In Great Toe In Diabetes?

49yrs old female, type2 diabetes for 7 yrs, bilateral great toe ulcers, non healing for last 1 year, HbA1c-9% , VPT and HCP-grossly impaired, ABI:right-1.01, left-0.92 1. what other information do you require from this patient? 2. what is the primary goal of treatment for her?
Mon, 26 May 2014
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Diabetologist,  's  Response
Hi nice to see you again
thanks for doing ABI and giving me the report.
As per her ABI index is good i guess she is having adequate blood supply.
Next make sure the wound is not infected and there is no osteomyelitic changes to find about this X Ray will help you.
Next and important step is off loading of foot .
i suggest fore foot off loading foot ware with Mcp coating and even rocker bottom also helps better.
Primary goal of treatment---Avoid pressure on wound and diabetic control to be maintained
Best Regards.
Dr Vamsi Krishna
Consultant Diabetologist
Apollo Hospitals
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What Causes Abnormal Ulcers In Great Toe In Diabetes?

Hi nice to see you again thanks for doing ABI and giving me the report. As per her ABI index is good i guess she is having adequate blood supply. Next make sure the wound is not infected and there is no osteomyelitic changes to find about this X Ray will help you. Next and important step is off loading of foot . i suggest fore foot off loading foot ware with Mcp coating and even rocker bottom also helps better. Primary goal of treatment---Avoid pressure on wound and diabetic control to be maintained Best Regards. Dr Vamsi Krishna Consultant Diabetologist Apollo Hospitals