Diabetic Foot Files

This episode explores King Louis XIV's chronic infections, his catastrophic anal abscess and fistula, and the brutal pre-anesthesia surgery that ultimately saved him and advanced surgical practice across Europe. It connects those historical lessons to modern wound care—showing why drainage, imaging, and timely intervention remain critical today, especially in diabetic foot infections.

Dr. G explores how unrelieved pressure — not just diabetes or infection — can destroy tissue, using Napoleon Bonaparte’s chronic foot pain, stiff military boots, and relentless marching as a historical case study. The episode explains how tight footwear, prolonged weight-bearing, cold, and vascular compromise lead to ischemia and pressure ulcers, and why pain, calluses, and blisters are important warning signs. The clinical takeaway: offloading is not optional — it’s treatment. Dr. G outlines modern management steps (assessment, offloading, pressure mapping, vascular referral, custom orthotics, and physical therapy) and shows that wound care requires whole-body thinking, not just local fixes.

This episode of Diabetic Foot Files focuses on Klebsiella pneumoniae as an emerging and dangerous pathogen in diabetic foot ulcers, highlighting its capsule, biofilm formation, and rising antimicrobial resistance. It covers clinical presentation, the importance of deep tissue cultures, diagnostic tips, and a three-pronged treatment approach: source control (debridement), mechanical offloading, and targeted antimicrobial therapy with infectious disease involvement for ESBL or carbapenem-resistant strains. The episode also reviews prevention strategies, the role of vascular assessment, and current research directions including anti-biofilm approaches and adjunctive therapies.

In this episode of Diabetic Foot Files Dr. G opens the mini-series "Royal Wounds" by asking whether King Henry VIII’s notorious, years-long lower-leg wounds were due to diabetes, venous disease, or a mixed cause. Using historical accounts of his obesity, post-jousting trauma, chronic swelling, foul drainage, and fluctuating pain, the episode argues that his wounds most closely match chronic venous or mixed-etiology ulcers worsened by metabolic dysfunction. The episode also outlines how modern clinicians would evaluate and treat such wounds—vascular studies, glucose control, compression, debridement, and multidisciplinary care—and emphasizes that correct diagnosis, not status or money, is what heals chronic wounds.

Dr. G interviews Dr. Andronica Handie, DPM, MS about combining his background in nuclear medicine and biopharmaceutical sciences with podiatric innovation to tackle onychomycosis in diabetic patients. They discuss TripleClear HF, an all‑natural topical antifungal using nanotechnology to penetrate nail plates, trial results showing marked reductions in nail thickness, and safety advantages over systemic antifungals. Takeaways: TripleClear HF can be used preventively or as primary therapy to reduce fungal burden, improve compliance through rapid visible effects, and may play a role in long‑term diabetic foot hygiene and limb preservation alongside blood sugar control and daily foot checks.