Diabetic Foot Files

In this episode Dr. G explains how the phrase "path of least resistance" applies to diabetic foot infections and why a small surface ulcer can hide extensive, limb‑threatening disease.

He reviews surgical principles (incision, drainage, debridement), vascular assessment, multidisciplinary limb salvage strategies, and the importance of timely follow‑up, offloading and patient engagement.

Early recognition, coordinated care and persistence can often save function and mobility that would otherwise be lost to amputation.

This episode explains toe pulp (felon) infections and why a tiny wound at the tip of the toe can become a serious problem, especially in people with diabetes and neuropathy.

It covers causes (puncture wounds, ingrown nails), anatomy, signs to watch for, imaging, the importance of vascular assessment and source control, and why offloading and timely care matter.

Dr. G explores the idea that wounds carry bioelectrical signals that guide cell movement and repair, and that diabetes can disrupt these electrical instructions in diabetic foot ulcers.

The episode reviews how researchers measure wound electrical fields, how hyperglycemia may impair them, and whether targeted electrical stimulation could restore polarity and improve healing, with implications for future limb-preserving care.

Dr. G explores the potential of autologous fat grafting for diabetic foot ulcers, explaining how adipose-derived cells may aid angiogenesis, modulate inflammation, and restore soft-tissue padding to improve healing and reduce recurrence.

The episode outlines biological mechanisms, procedural considerations, risks, and the need for vascular assessment and offloading, presenting fat grafting as a promising adjunctive regenerative strategy—not a standalone replacement for standard wound care.

Episode Summary

Where Are Your Shoes? Turning Family Conversations Into Diabetic Foot Surveillance | LIMBWatch with Jonathan Brocklehurst

In this episode of LIMBWatch, Dr. Gabrielle Hutcheson Donaldson sits down with Jonathan Brocklehurst MSc, MIRL, MRCPod, HCPC Registered Podiatrist, wound-care specialist, educator, and author of Grandpa, Where Are Your Shoes? for a powerful conversation about one of the most overlooked components of limb preservation: early observation and prevention.

Jonathan shares the journey that led him from podiatry and amputee care to wound healing, health literacy, and ultimately writing a children’s book designed to make diabetic foot education accessible across generations. At the heart of the conversation is a deceptively simple question:

“Where are your shoes?”

Jonathan explore how footwear can provide clues about what is happening to the foot—from abnormal wear patterns and pressure to rubbing, deformity, instability, and potential sources of tissue breakdown. They discuss why people living with diabetes and neuropathy may not feel injuries developing, making daily visual inspection of the feet and shoes particularly important.

But this episode goes far beyond footwear.

Jonathan explains why children and family members can become important partners in diabetic foot surveillance without becoming amateur clinicians, and how simple conversations at home can help reduce stigma, isolation, and health-literacy barriers. The discussion explores the powerful relationship between grandparents and grandchildren—and how a child’s seemingly innocent question can open the door to conversations about diabetes, neuropathy, footwear, prevention, and seeking professional care.

The conversation also tackles health equity and footwear affordability, emphasizing that effective diabetic foot prevention must account for social determinants of health and the realities of patients’ lives outside the clinic.

In a rapid-fire finale, Jonathan addresses some of the biggest misconceptions surrounding diabetic feet, including the dangerous idea that “if it doesn’t hurt, it isn’t a problem.” He also shares practical advice on daily foot checks, footwear, hygiene, and avoiding potentially harmful DIY foot care.

Ultimately, this episode asks us to rethink diabetic foot surveillance. It doesn’t always begin with advanced technology or a wound—it can begin with a question, a pair of shoes, a family conversation, and someone noticing that something has changed.

Because sometimes, limb preservation begins at home.

Where are your shoes?
Check your feet. Check your shoes. Protect every step.