Today I share with you the true story of how something so small as a paper clip can lead to a life threatening situation for a Diabetic. I tell you this story as a podiatrist who has treated diabetic patients for over 30 years, and seen many devastating complications resulting from diabetes. It is my hope that this story will help you avoid such complications.

Robert Johnson is a retired attorney as well as a diabetic suffering from peripheral neuropathy and poor circulation in his legs and feet. When we first met, he was my patient in the intensive care unit. When Mr. Johnson accidentally stepped on a paper clip, a piece of it broke off and penetrated into his heel. Due to his neuropathy, he never felt the paper clip and did not take any action until he developed a fever and noticed blood and pus in his socks. Soon after, his wife called 9-1-1 and Mr. Johnson spent the next four weeks in a coma diagnosed with blood poisoning, and a foot so badly infected that his doctors believed his foot would need to be amputated.

Unfortunately, a diagnosis such as this is all too common for those suffering from diabetes. According to the Center for Disease Control, more than 60% of non-traumatic lower limb amputations occur in people with diabetes. However, while the probability of devastating foot complications may be increased for diabetics, prevention is still possible.

Mrs. Johnson told me that her husband did not properly manage his diabetes. He would cheat, she said, by taking more insulin when he went off his diet. Furthermore, he never paid much attention to his feet, though he suffered from leg cramps in his sleep and was unable to walk very far. Normally, a patient might have noticed the paper clip sooner and would have removed it before further complications. Poor self management of his diabetes added severity to this minor problem.

Fortunately for Mr. Johnson, he would not lose his foot. At the cost of four weeks in a coma, two months of intravenous antibiotic treatment, and two operations, he was able to stop the spread of the infection caused by the paperclip. After subsequent skin grafting and four months in a wheelchair, Mr. Johnson finally became fully healed.

It is my hope that Mr. Johnson’s story will show you the importance of maintaining proper care of your feet when managing your diabetes, a lesson he learned through this difficult process. Alongside proper diet and exercise, remember to take care of your feet. There are many diabetic socks and diabetic shoes designed specifically for diabetics, and available for you to take advantage of which, when combined with simple daily monitoring of your feet can help you avoid Mr. Johnson’s situation.


NOTE: Consult your doctor first to make sure my recommendations fit your special health needs

Mark Warren, DPM

Dr. Mark Warren is a Board Certified podiatrist located in South Florida. He is also Board Certified in Foot and Ankle Surgery as well as a Board Certified Wound Care Specialist. He is a graduate of the William Scholl College of Podiatric Medicine located in Chicago, Illinois and completed his residency in foot and ankle surgery at Genysis Hospital located in Flint, Michigan.
For over 25 years, Dr. Warren has been practicing podiatry in Delray Beach, Florida, where he divides his time between seeing patients in both his private practice as well as the wound care center for Delray Medical Center. Furthermore, Dr. Warren is an affiliate faculty member at the Boca Raton campus of the University Of Miami School Of Medicine, which follows his previous teaching position as an adjunct faculty member at Barry University College of Podiatric Medicine. He has also been an instructor for laser and endoscopic foot surgery.

Latest posts by Mark Warren, DPM (see all)