Diabetic Foot Files

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.

Dr. G breaks down the Unna boot: its origin, ingredients (zinc oxide, glycerin, gelatin), and how its semi‑rigid, inelastic compression helps venous stasis ulcers. He compares Unna boots to modern multi‑layer systems, explains the pressure mechanics and therapeutic targets, and highlights practical application tips.

Key cautions are emphasized: always assess vascular status/ABI before compressing, avoid use with critical arterial disease, heavy drainage, active infection, non‑ambulatory patients, or purely neuropathic plantar ulcers. Compression must be individualized and combined with correct diagnosis and overall wound care.

Dr. Tom Hardiman DPM draws on decades of experience in podiatry and limb salvage to reveal how systemic inequities and barriers to care drive preventable amputations in people with diabetes. He explains the social determinants of health—housing instability, food insecurity, lack of transportation—and how unequal access to vascular care, nutrition, and timely treatment leads to worse outcomes for underserved communities.

Hardiman shares personal patient stories, emphasizes the importance of patient advocacy and education, and calls for policy changes that prioritize health equity over profit to reduce the 175,000 annual amputations in the U.S. and improve limb salvage for everyone.