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Diabetic Foot Care & Ulcer Treatment in Brighton, MI

Diabetes affects nearly 30 million Americans — and the feet are one of the first places complications show up. Diabetes impairs the body’s ability to use insulin properly, which over time can affect the skin, nerves, blood vessels, and bones of the foot and ankle. Changes in skin color, numbness, swelling, pain, and open sores can all develop if diabetes is not carefully managed.

Many times diabetes affects the foot and ankle.

A podiatrist is a critical part of any diabetes healthcare team. Dr. Castelein performs annual diabetic foot exams to assess risk for peripheral vascular disease, peripheral neuropathy, and foot deformities, while evaluating overall skin and tissue health. Any areas of concern are addressed with a specific, individualized treatment plan focused on protecting your feet and preventing future complications.

Schedule Online
1-810-227-3864

Understanding Your Risk Level

Not all diabetic patients have the same level of risk. Dr. Castelein categorizes diabetic foot risk and adjusts the frequency of exams accordingly:

  • Low risk — diabetes without neuropathy or peripheral arterial disease. Annual foot exam recommended.
  • Moderate risk — diabetes with neuropathy. Exams recommended every six months. Loss of protective sensation means wounds can go unnoticed and progress quickly.
  • High risk — diabetes with neuropathy, foot deformity, and/or peripheral arterial disease. More frequent exams recommended. Multiple system failures put patients at very high risk of ulceration and slow or non-healing wounds.
  • Highest risk — history of ulceration or amputation. Immediate care for any sign of redness, blistering, or open sores. Early intervention is always the best treatment.

Regardless of risk level, patients are encouraged to call the office immediately at the first sign of any foot problem rather than waiting for their next scheduled appointment.

Peripheral Neuropathy

Peripheral neuropathy is damage to the smaller sensory nerves outside the brain and spinal cord — the nerves responsible for protecting the body from the outside world. Common symptoms include pins-and-needles, burning, tingling, pain, or numbness in the feet and ankles. Uncontrolled diabetes is the most common cause, though autoimmune diseases, infections, vascular conditions, and other factors can also contribute.

Neuropathy is largely irreversible, which makes early diagnosis and risk reduction critical. Dr. Castelein may use advanced testing — including epidermal nerve fiber density testing (ENFD), electromyography (EMG), or nerve conduction velocity (NCV) — to confirm the diagnosis and measure severity. Treatment focuses first on addressing the underlying cause, then on managing symptoms through nerve-supportive vitamins, foot braces, accommodating footwear, and therapies to maintain muscle health and coordination.

Ulcer Care

A diabetic foot ulcer is an open wound or sore on the foot, toes, ankle, or leg that requires prompt medical attention — ulcers will not heal on their own. Patients with diabetes, peripheral neuropathy, poor circulation, or foot deformities are at higher risk. Because neuropathy reduces sensation, ulcers can go unnoticed until they become infected, significantly increasing the risk of serious complications including amputation.

Dr. Castelein tailors every ulcer treatment to the specific wound and the patient’s overall health. Treatment may include:

  • Offload pressure from the area
  • Removing dead skin and tissue from the affected area
  • Apply cutting-edge wound graft technology on the affected area
  • Prescribe antibiotics as needed to resolve infection
  • Evaluating systemic factors such as peripheral vascular disease and diabetes

After healing, Dr. Castelein offers regular follow-up exams and personalized prevention strategies — including footwear recommendations, advanced shoes or braces, and guidance on blood glucose management — to reduce the risk of future ulcers.

Charcot Foot

 Charcot foot is a rare but serious deformity affecting diabetic patients with advanced neuropathy. It causes progressive damage to the bones, joints, and soft tissues of the foot and ankle, potentially leading to difficulty walking, bone loss, and in severe cases, amputation. Symptoms include prolonged pain, redness, swelling, and warmth in the affected foot. As the condition advances, the bone structure shifts — altering foot function and increasing the risk of ulcers and instability.

Dr. Castelein diagnoses Charcot using X-rays and physical examination, then focuses treatment on halting bone change and preventing further deformity. Immobilization and reduced weight-bearing are typically recommended during the initial healing phase, along with bone stimulators to support recovery. Once the foot has stabilized, protective footwear — including splints, braces, orthotics, or offloading devices — is prescribed to minimize future complications.

Diabetic Shoes

Proper footwear is one of the most effective tools for protecting diabetic feet. Diabetic shoes reduce the risk of ulcers, calluses, and skin breakdown by providing targeted support, pressure relief, and protection. Dr. Castelein assesses each patient’s needs, carefully measures their feet, and offers a selection of over 100 styles.

Diabetic shoes are:

  • Wider in the toe box, allowing room to move without developing cuts or blisters
  • Stabilizing which can decrease the amount of scrapes and falls
  • Protective to prevent diabetic foot ulcers

The simplest advice Dr. Castelein gives every diabetic patient: wear shoes at all times, check your feet daily, and never skip your annual exam.

Daily Self Care Tips

Dr. Castelein recommends all diabetic patients follow these daily habits:

  • Inspect your feet every day for cuts, blisters, redness, or swelling
  • Wash feet daily and dry thoroughly especially between the toes
  • Moisturize to prevent dry skin but avoid putting lotion between the toes
  • Never walk barefoot — always wear shoes or slippers even indoors
  • Trim toenails straight across and avoid cutting too close to the skin
  • Call the office immediately at any sign of a problem — do not wait for your next appointment

Managind Diabetes Starts With Your Feet.

Regular podiatric care is one of the most important things a diabetic patient can do. Book your annual exam or consultation online or call us today.

Schedule Online
1-810-227-3864

What Our Clients Think

Client Testimonials

Julie
I'm so happy to have found Brighton Foot And Ankle in Brighton. The office staff and assistant are very pleasant. Dr. Bryant Castelein is a great knowledgeable Dr. Who has eased my worry over my medical condition. Plus he's handsome. I would highly recommend this practice for anyone needing podiatry help.
Amy
What great people to help you! From receptionist to doctor, they are top notch! You would not regret going here for any of your foot/ankle problems, they will fix you up with the utmost care and compassion.
Yo K
Dr. Castelein and staff were friendly, knowledgeable , efficient and took the time to get to know me and understand my medical needs. I would not hesitate to go to Brighton Foot & Ankle. They go out of their way to treat their patients like family.
Robert
Dr. Castelein is great; he is very nice, patient, and professional. His staff is also excellent and friendly. It's only been about three hours since having my big toenail removed and, with acetaminophen and ibuprofen, there is very little pain(sometimes I completely forget about it); he did an excellent job. Overall, I am very impressed with Dr. Casteleins Practice and I would highly recommend his office.
Joseph
Doctor & staff were so professional, friendly & efficient. I had a high risk condition that they expertly guided me through 5 months of healing. Thankfully a full recovery. I give them my best recommendation.
Lexi
Very friendly and accommodating front desk staff. Dr. Castelein and Jennifer always take their time and do an amazing job! Great variety of quick pick up over the counter products that are always affordable too. Best experience I have had at an office.
Christena
Dr. Castelein is very friendly and extremely knowledgeable in his field. During my visit he did a great job explaining my situation and was very encouraging of any questions. I never felt rushed and I believe to have received the best care possible. Highly recommend this doctor and this facility.
Nicole C
Excellent staff and exceptional doctor. I went in with Bunion issues. Dr. Castelein listened to my concerns and addressed my options. 4 days post-op bunion surgery I can say he did an amazing job. Best experience I have ever had. I would definitely recommend; I promise you won't look further.
Ashley
The staff and Dr. Castelein are all amazing. They are polite and very respectful. I came to see them in 2019 for bunion and hammer toe issues among some others. Dr. Castelein and his assistant listened to my concerns and gave me my options. He explained everything to me in detail and all my questions were answered.. I have seen other podiatrists and he is beyond the best. I would recommend him to anyone.
Alex
Friendly staff and intelligent doctor! I went in for some ankle X-rays and was given a great strategy on the different ways to heal my ankle, and how to progress forward if less invasive treatment doesn't help. I would highly recommend them to anyone with foot or ankle problems!