Diabetic Foot Files

Dr. G reviews necrotizing fasciitis—its history, classification, and why missed diagnosis is often fatal—especially in diabetic patients. Learn the red flags (deep pain, rapid progression, gray “dishwater” drainage), key labs (CRP >150, hyponatremia, lactate), and the LRINEC score.

This episode emphasizes rapid recognition, use of bedside ultrasound, aggressive labs and imaging, immediate surgical consultation, and early broad-spectrum IV antibiotics plus debridement—because early action saves lives.

In this episode of Diabetic Foot Files Dr. G explains disseminated intravascular coagulation (DIC): what it is, how severe diabetic foot infections (like necrotizing fasciitis and osteomyelitis) can trigger it, and why early recognition matters.

Learn common triggers, key lab patterns (thrombocytopenia, prolonged PT/aPTT, low fibrinogen, very high D-dimer), urgent management steps (source control, ICU care, transfusions, cautious heparin) and practical warnings to prevent escalation.

The episode stresses listening to patients, drawing timely labs, and treating the cause—because early action can mean saving a life, not just a limb.

In this special episode of Diabetic Foot Files, host Dr. G engages in an insightful discussion with Riley Sernica, the Vice President of Product Development at Darco .Together, they explore the innovation behind the Darco Pogo shoe, a groundbreaking development in diabetic foot care designed with intentional offloading to promote healing and prevent ulceration.

Riley shares the journey from conceptualization to realization of the Pogo shoe, highlighting the significance of pressure offloading in diabetic foot ulcer management. They delve into the unique design features of the shoe, inspired by real patient stories, and discuss how it marries fashion with functionality, ensuring comfortable wear without compromising on style.

Listeners will gain insights into the impact this innovative shoe can have on patient compliance, the role of advanced materials in promoting wound healing, and Darko's vision for the future of diabetic footwear - a shoe for everyone, not just those with diabetes. This episode is a testament to the potential of fashion-driven health solutions in transforming lives.

This episode explains why podiatrists are often the first clinicians to detect peripheral arterial disease in diabetic patients, describing common signs—shiny skin, hair loss, delayed capillary refill, painful ulcers and nondetectable pulses—and the pathophysiology behind early ischemia.

It outlines the importance of prompt vascular referral, diagnostic tests (ABI, toe pressures, duplex), and early interventions to improve limb salvage and reduce major amputations, advocating annual vascular evaluation for people with diabetes.

Dr. G explains how lidocaine works, why its chemistry matters, and how too much—especially on open, inflamed, or diabetic wounds—can cause serious central nervous system and cardiac toxicity.

The episode covers safe dosing calculations, differences between wound types, safer alternatives for anesthesia, and first-aid steps if toxicity occurs, emphasizing caution and medical supervision.