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Diabetic Foot Files — Health & Fitness
Diabetic Foot Files

THE DIABETIC FOOT FILES HAS A NEW HOME!

The brand-new Diabetic Foot Files website is LIVE!

Welcome to the digital home of everything diabetic foot, wound care, limb salvage, and beyond. From the latest podcast episodes and expert conversations to LIMBWatch, educational content, and resources for the limb-salvage community — it’s all coming together in one place.

www.diabeticfootfiles.com

Whether you’re a clinician, researcher, student, patient, advocate, or simply passionate about saving limbs — there’s a place for you here.

Listen.
Learn.
Think beyond the wound.
Save the limb. Change the life.

Welcome to the next chapter of Diabetic Foot Files.

👟✨ We’ve teamed up with DARCO to bring you 25% off the POGO shoe! Want to stay active, reduce pressure, and help prevent ulcers before they begin? Visit darcodirect.com/product/pogo/ and use our exclusive code FootFiles25 at checkout to save 25% off your pair.

Welcome to the Diabetic Foot Files Podcast and the LIMBWatch series — where diabetic foot surveillance, wound intelligence, prevention science, and limb preservation come together. I’m Dr. G / Dr. WoundPicasso aka Dr. Gabrielle Hutcheson Donaldson, podiatrist and wound care specialist, and I’m here to educate, empower, and guide you through the evolving world of diabetic foot care.

From wound healing and pressure injuries to surveillance systems and amputation prevention, we break down the science, challenge the myths, and share strategies that help save limbs and improve lives. Whether you’re a patient, caregiver, clinician, or healthcare professional, this is your destination for diabetic foot education, prevention, and preservation.

So let’s dive in — because when you take care of your feet, they take care of you.
LIMBWatch: Surveillance Before Salvage- World Leaders in LIMB Salvage

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Copyright: © Copyright 2025 All rights reserved.

Latest Episodes:

Teeth in the Tide- When the Ocean Bites: Barracuda Strike and Diabetic Foot Danger Aug 15, 2026

Show notes

In this episode Dr. G recounts a surprising barracuda bite that exposes the challenges of marine injuries, especially for people with diabetes. The episode explains how sharp lacerations, contamination from seawater, retained debris, and organisms like Vibrio can turn a beach wound into a serious infection.

Key takeaways include immediate bleeding control and irrigation, careful wound assessment (tendons, bone, foreign bodies, tetanus status), cautious use of closure and targeted antibiotics, and the importance of early medical attention — particularly for patients with neuropathy or impaired healing.

Forgotten Infection Friday- Madura Foot: The Silent, Years-Long Infection Hiding in Plain Sight Aug 15, 2026

Show notes

This episode reviews Madura foot (mycetoma), a chronic implantation infection characterized by long-standing swelling, multiple sinus tracts, and visible ‘‘grains.’p>

There are two main types — eumycetoma (fungal) and actinomycetoma (bacterial) — with different treatments (antifungals ± surgery vs prolonged antibiotics). Diagnosis relies on deep tissue sampling, culture, histology and imaging to define extent. Early recognition, protective footwear, and daily foot checks are key to limb preservation, especially in patients with diabetes and neuropathy.

LIMBWatch Series: Dr. Andrew JM Boulton, MD, DSc (Hon), FACP, FICP, FRCP-The Man Who Changed Diabetic Foot Care Dr. Andrew Boulton on Neuropathy, Prevention & Saving Limbs Worldwide Aug 10, 2026

Show notes

Welcome to LIMBWatch — the global movement dedicated to protecting limbs, preventing amputations, and transforming the future of diabetic foot care.

In this landmark episode, we welcome one of the world’s most influential leaders in diabetes and diabetic foot disease — Dr. Andrew Boulton, a pioneer whose research, leadership, and advocacy have shaped modern approaches to neuropathy, diabetic foot screening, and limb salvage.

With more than 600 peer-reviewed publications, an H-index exceeding 130, and decades of international leadership including roles with global diabetes organizations, Dr. Boulton shares lessons from a lifetime dedicated to one mission: preventing unnecessary amputations and improving the lives of people living with diabetes worldwide.

In this powerful conversation, Dr. Boulton discusses:

🦶 Why diabetic neuropathy can remain silent until it is too late
🦶 The life-changing importance of annual diabetic foot screening
🦶 Why “take off the shoes and socks and look at the feet” remains one of the most powerful tools in medicine
🦶 The misconception that amputation is an inevitable outcome of diabetic foot disease
🦶 How multidisciplinary foot teams can transform limb salvage outcomes
🦶 Why prevention must become the future of diabetic foot care
🦶 The role of AI and technology in identifying high-risk patients
🦶 Why evidence-based medicine is essential for advancing wound healing treatments
🦶 The overlooked importance of footwear, offloading, biomechanics, and patient-centered care
🦶 The future of global diabetic foot initiatives and making limb preservation accessible everywhere

Dr. Boulton also shares personal reflections from his career, including lessons learned from patients, his admiration for pioneers like Dr. Paul Brand, and why the greatest reward in medicine is not financial success — but the ability to change lives.

His message is clear:

Diabetic foot complications are preventable. Screening saves limbs. Early intervention saves lives.

This episode is a must-listen for healthcare professionals, patients, researchers, policymakers, and anyone committed to building a future where amputations become less common and limb salvage becomes the global standard.

This is LIMBWatch — because every limb matters.

Antimicrobial ≠ Antibiotic: Antimicrobial Doesn’t Mean Antibiotic Aug 09, 2026

Show notes

This episode clarifies the difference between antimicrobials (agents that act against a range of microorganisms) and antibiotics (drugs that specifically target bacteria), and explains related terms like antiseptics, contamination, colonization, and infection in diabetic foot ulcers.

Dr. G reviews when topical antimicrobial dressings are appropriate, why they do not automatically replace systemic antibiotics, and how debridement, source control, and wound biology guide treatment decisions.

Key takeaways focus on evaluating the wound, understanding product mechanisms, avoiding unnecessary antibiotics through stewardship, and choosing interventions that help heal the patient and protect the limb.

Why Your Healed Wound Still Feels Tight — What Causes Tight Skin After Diabetic Foot Wounds Aug 08, 2026

Show notes

This episode explains why healed wounds can feel tight, covering the stages of wound healing, the role of myofibroblasts and alpha-SMA in wound contraction, and how scar tissue differs from normal skin.

It discusses how diabetes alters healing, the long remodeling phase (months to over a year), practical care tips like moisturization and follow-up, and warning signs that require prompt medical attention.

Forgotten Infection Friday: Rhodococcus equi — The Macrophage‑Hiding Threat Aug 07, 2026

Show notes

This episode explores Rhodococcus equi — a pink, soil‑associated bacterium historically linked to horses that can survive inside macrophages and mimic tuberculosis in the lungs.

Dr. G discusses its discovery, how humans become exposed, diagnostic clues (culture, MALDI‑TOF, PCR), challenges in treatment (intracellular survival, prolonged combination antibiotics, and need for surgical source control), and its importance in immunocompromised and diabetic foot wound patients.

Diabetic Foot Ulcers Aren’t Paper Cuts: When Triple Antibiotic Is Not Enough Aug 06, 2026

Show notes

This episode traces the history and science behind triple antibiotic ointment—its three ingredients (bacitracin, neomycin, polymyxin B), how they attack different bacteria, and why it became a household staple for minor cuts.

It explains why diabetic foot ulcers are fundamentally different from everyday wounds—driven by neuropathy, poor blood flow, chronic inflammation, biofilm, and deeper infection—and why a topical ointment cannot address these underlying problems.

The episode also covers risks of using ointment on diabetic ulcers (maceration, contact dermatitis, altered wound microbiome), the difference between colonization and infection, and the importance of prompt medical assessment, vascular evaluation, offloading, debridement, glucose control, and specialized wound care.

LIMBWatch Series: Dr. Thomas Hardiman- 10-Gram Truth: How a Simple Monofilament Saves Feet Aug 03, 2026

Show notes

Episode Title:
The 10-Gram Test That Can Save a Limb: Understanding Monofilament Screening, Neuropathy & Prevention with Dr. Thomas Hardiman

Episode Summary:

What if one of the simplest tools in diabetic foot care could help prevent devastating complications before they happen?

In this powerful episode of LIMBWatch on Diabetic Foot Files, Dr. Gabrielle Donaldson sits down with Dr. Thomas Hardiman, a podiatric surgeon with over 40 years of experience in foot and ankle care and a pioneer in diabetic foot screening through his work with medical monofilament technology.

Together, they take a deep dive into the science, history, and clinical importance of the 10-gram monofilament examination — a simple yet powerful tool used to identify loss of protective sensation (LOPS) and help recognize patients at risk for diabetic foot ulcers and amputations.

Dr. Hardiman reveals the fascinating story behind the development of the monofilament, from early sensory testing pioneers to the influence of Dr. Paul Brand’s groundbreaking work, and explains why prevention starts by “going upstream” rather than waiting until patients present with wounds.

In this episode, you’ll learn:

🦶 How the 10-gram monofilament actually works and what is happening at the nerve level when sensation is lost
🧬 How chronic hyperglycemia damages nerves through metabolic pathways, myelin injury, and impaired sensory signaling
⚠️ Why neuropathy is not simply “numbness” — but the loss of the body’s protective alarm system
🔍 Why a patient can have a normal monofilament exam and still remain at risk for ulceration
🎵 The difference between monofilament testing, vibration perception testing, and tuning fork examinations
📋 The correct technique, anatomical testing sites, and common mistakes clinicians make
🦠 Why single-use monofilaments matter for accuracy and infection prevention
👟 The importance of examining footwear and how a hidden foreign object can lead to a recurring ulcer
🤖 How artificial intelligence may transform diabetic foot surveillance and help identify high-risk patients earlier
❤️ Why patient education, daily foot inspections, and prevention remain some of the most powerful limb-saving interventions

Dr. Hardiman shares unforgettable clinical lessons, including a patient whose heel ulcer repeatedly returned because a nail hidden inside his shoe was causing repeated trauma — a reminder that sometimes the most important diagnostic tools are simply looking, listening, and paying attention.

He also challenges the healthcare community to rethink the phrase “silent epidemic,” explaining why diabetic foot complications are not silent and why calling them that may unintentionally create acceptance instead of urgency.

His message to patients is clear:

“Your feet should last a lifetime, and with proper care, they can.”

This episode is a reminder that limb preservation does not always begin with the newest technology. Sometimes it begins with mastering the fundamentals, performing them consistently, and empowering patients before the first ulcer ever develops.

Join us for an eye-opening conversation about neuropathy, prevention, screening, and the simple test that can help change the future of diabetic limb health.

Key Takeaway Quote:
“We don’t sell monofilaments. We partner in prevention.” — Dr. Thomas Hardiman

🦶 A 10-gram filament can change the future of a limb.

Before a diabetic foot ulcer appears, there may be a silent warning sign: loss of protective sensation.

Dr. Hardiman, Medical Director of Medical Monofilament, explains why proper monofilament testing matters — helping clinicians identify the “foot at risk” and take action before a small problem becomes a devastating complication.

The right tool. The right technique. The right time.

Learn more about Medical Monofilament technology:
🔗 https://www.medicalmonofilament.com

The evolutionary purpose of diabetic neuropathy & Why Our Alarm System Fails in the Modern World and How The Healthcare System becomes that External Warning System for the Patient Aug 02, 2026

Show notes

This episode explores why pain evolved as a critical protective alarm and how diabetes—through chronic high glucose, inflammation, and microvascular damage—silences that alarm by injuring peripheral nerves.

It explains the biological pathways behind diabetic neuropathy, why the feet are especially vulnerable, how repetitive pressure and biofilm-forming bacteria turn painless injuries into ulcers, and the stepwise cascade from nerve damage to amputation.

The episode emphasizes prevention and the clinician’s role as an external warning system: early screening, offloading, proper footwear, glucose control, vascular assessment and coordinated limb-salvage care to protect patients’ feet.

Gossypiboma: The Hidden Sponge Sabotaging Wound Healing Aug 01, 2026

Show notes

This episode explains gossypiboma (retained surgical sponge), how the body mounts a foreign‑body granuloma response, and why these sponges can mimic infection or tumors and lead to chronic inflammation.

It highlights the added danger for people with diabetes (impaired immunity, poor circulation, neuropathy), shares a real diagnostic case, and reviews prevention steps like sponge counts, radiopaque markers, barcode systems, and surgical timeouts. The key message: persistent non‑healing wounds often need a detective approach to look beneath the surface.

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