In this episode Dr. G explains “acute on chronic” in diabetic foot care — when a long-standing ulcer or osteomyelitis suddenly deteriorates into an aggressive, limb- or life-threatening infection.

He outlines common triggers (trauma, ischemia, new organisms, high glucose), the red flags to watch for (increased pain, purulent drainage, erythema, gas, bullae, systemic signs), and key diagnostics and treatments (labs, MRI, bone biopsy, antibiotics, debridement, vascular assessment, and possible surgery).

Practical prevention tips are highlighted: offloading, regular debridement, strict glycemic control, vascular optimization, and close monitoring to catch flares early and reduce the risk of amputation.