Diabetic Foot Files

Dr. G returns to the foundation of diabetic limb salvage, explaining essential ulcer terminology—erosion, partial/full-thickness ulcers, tunneling, undermining, exudate types, wound bed tissue, biofilm, and signs of infection—and how to measure and document them.

Clear, accurate wound language improves diagnosis, care coordination, coding, and outcomes; this episode includes practical examples and a sample documentation template to...

Dr. G explains porokeratosis — a ring-like skin disorder that can masquerade as a callus or wart and cause pain, ulceration, and even malignant change on diabetic feet. The episode covers what porokeratosis looks like, why people with diabetes are at higher risk of complications, and when to biopsy.

Practical advice includes daily foot checks, avoid self‑debridement, early offloading and specialist referral, medical and procedural ...

Dr. G (Woon Picasso) exposes the hidden crisis of diabetic foot disease in prisons: its prevalence, the resource and policy barriers that lead to missed checks and preventable amputations, and the moral and legal imperative to provide care.

The episode outlines practical, low-cost prevention and treatment steps—intake screening, annual and monthly checks, proper footwear, telemedicine, wound kits, offloading, and urgent referral pa...

Dr. G explains how silver nitrate works as a quick, low-cost chemical cautery for treating hypergranulation ("proud flesh") in diabetic and other chronic wounds, outlining the mechanism, application steps, and the expected gray discoloration.

He summarizes benefits—rapid control of excess granulation, antimicrobial action, and minor hemostasis—along with key cautions such as pain, staining, tissue damage, and contraindications (inf...

Dr. Gabrielle Hutchison Donaldson dives into the 2025 Nobel Prize in Physiology or Medicine for discoveries about regulatory T cells (T‑regs), explaining why these immune brakes matter and how they control self‑tolerance.

The episode links T‑reg biology to diabetes and diabetic foot ulcers, covering mechanisms, early T‑reg therapies, and how boosting regulatory pathways could reduce chronic inflammation and improve wound healing.

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This episode explains the piezoelectric effect—how mechanical stress creates tiny electrical signals—and how those signals guide cell migration, angiogenesis, collagen deposition, and epithelialization in wound healing.

It describes how diabetes weakens natural bioelectrical cues through neuropathy, poor circulation, and collagen changes, and reviews clinical approaches that restore or mimic these signals: electrical stimulation, l...

Dr. G explains when to use IV versus oral antibiotics for diabetic foot infections, covering severity-based choices, common empirical regimens, and why wound cultures matter.

The episode reviews pharmacokinetics, expected timelines for improvement (48–72 hours), typical durations for soft-tissue infection and osteomyelitis, and criteria to step down from IV to oral therapy.

It also highlights monitoring, common side effects and dru...

Dr. G interviews Emmy winning journalist Kym  Nicholas, CEO and co‑founder of the Global PAD Association, about peripheral arterial disease (PAD), its strong link to diabetes, common misdiagnoses, and why early vascular evaluation can prevent unnecessary amputations.

They discuss patient stories, systemic gaps in care, lifestyle interventions like supervised walking programs, global best ...

In this episode of Diabetic Foot Files, Dr. G explores how existing medications — from metformin and insulin to statins, fentanyl, sildenafil, doxycycline and nitric oxide donors — are being repurposed to help heal stubborn diabetic foot ulcers. We review the biology behind each drug, early clinical evidence, and why topical formulations may offer targeted benefits with minimal systemic exposure.

Listeners will learn which agents s...

This episode explores new randomized evidence that semaglutide, a GLP-1 receptor agonist used for diabetes and weight loss, can improve walking distance and quality of life for people with type 2 diabetes and symptomatic peripheral arterial disease (PAD).

The landmark STRID trial showed median gains of about 26 meters (mean ~40 m) in walking distance over a year, along with better pain scores and daily function. Large real-world st...

In this episode of Diabetic Food Files we explain how peripheral arterial disease (PAD) and chronic kidney disease (CKD) interact in people with diabetes to worsen circulation, slow wound healing, and raise the risk of infection and limb loss.

We outline the key symptoms to watch for, recommended screening tests (ABI/toe–brachial index, urine albumin-to-creatinine ratio, eGFR), and why every person with diabetes should be evaluated...

This episode of Diabetic Foot Files explores peripheral arterial disease (PAD) in people with diabetes — its history, how diabetes accelerates arterial damage, the biology behind impaired wound healing, and clinical clues to distinguish ischemic from neuropathic ulcers.

We cover bedside tests (ABI, TBI, TcPO2), modern revascularization options, medical and lifestyle management, and emerging therapies, emphasizing early recognition ...

Dr. G explains how nicotine — from cigarettes, vapes, pouches, and nicotine replacement products — reduces blood flow, disrupts immune and cellular repair, and slows or worsens healing in diabetic foot wounds.

He summarizes the science, lists nicotine-containing products, and gives practical, evidence-based guidance for clinicians and patients on screening, cessation options, and wound-care strategies to improve outcomes while work...

This episode explains Monckeberg ("Mockingbird") sclerosis—a medial arterial calcification common in diabetes and chronic kidney disease—how it stiffens arteries without narrowing the lumen, and why it can make ABI results falsely reassuring.

Learn how to spot the classic railroad-track calcifications on x-ray, which vascular tests to use instead (toe-brachial index, duplex ultrasound, TcPO2), and why multidisciplinary care and opt...