From Dr. K

At East County Internal Medicine, we treat diabetes as a whole-body condition, but some of its most devastating effects happen where you might least expect: your feet. Diabetes is a “creeping” disorder that often progresses without pain, yet it is the leading cause of non-traumatic lower-limb amputations worldwide. When foot health is neglected, the transition from a minor blister to life-threatening sepsis can happen with alarming speed.

The Silent Erosion of Sensation and Circulation

The primary reason diabetes targets the feet is a “perfect storm” of nerve damage and poor blood flow. Peripheral neuropathy affects approximately 60% of people with diabetes, often beginning as a faint tingling before progressing to total numbness. Without the body’s natural “warning system” of pain, a patient might walk on a pebble or a small cut for days without realizing it.

Simultaneously, diabetes narrows the arteries, reducing the delivery of oxygen and nutrients needed for healing. This combination means that one-third of all individuals with diabetes will develop a foot ulcer in their lifetime.

From a Small Sore to a Life-Altering Crisis

Our office in Lakewood Ranch frequently sees the progression of these chronic issues from patients in surrounding Bradenton, Parrish, and Sarasota.

Diabetic Foot Ulcers: These are not just “sores.” Approximately 20% of moderate to severe foot ulcers result in some level of amputation.

Infection and Sepsis: Once an ulcer forms, it is highly susceptible to infection; in fact, 85% of diabetes-related amputations are preceded by a foot ulcer. If the infection reaches the bone (osteomyelitis) or enters the bloodstream, it can lead to sepsis, a life-threatening emergency with a mortality rate that can range from 15% to 30%.

Charcot Foot: This is a severe complication where bones in the foot fracture and the joints collapse because the patient cannot feel the injury. The risk of amputation is seven times higher for those with Charcot deformity compared to those with standard neuropathy alone.


The Severe Impact on Quality of Life

When you can no longer walk easily, every aspect of life changes. Patients with active ulcers or previous amputations report significantly lower quality of life, specifically in physical functioning and general vitality. The statistics on long-term outcomes are a sobering reminder of why early intervention is critical: the five-year mortality rate for an individual with a diabetic foot ulcer is 2.5 times higher than for those without one.

Our Commitment to Your Mobility

The good news is that between 50% and 80% of diabetic foot infections are preventable with proactive, multidisciplinary care. Most amputations can be avoided through regular screenings and immediate attention to even the smallest wounds.

If you have noticed any numbness, swelling, or slow-healing sores, do not wait for pain to develop—by then, it may be too late.

Book Your Diabetic Foot Exam Today at the East County Internal Medicine Patient Portal or call us at (941) 727-7771. We are here to help you keep your independence and stay on your feet.

“An informed patient is a healthier patient”

Shaan Kunwar DO

941-727-7771

In a fast-growing area like Bradenton and Lakewood Ranch, finding a Primary Care Provider (PCP) often feels like a part-time job. Most offices have a 3-week waitlist for new patients, and “big box” urgent care centers treat you like a number in a crowded waiting room.

At East County Internal Medicine, we’ve flipped the script.

We’ve combined a lean, all-cash model with telehealth accessibility to create a hybrid that works for you. Whether you are a walk-in, a caller, or a new resident without a local doctor, we offer the immediate response of an urgent care clinic with the personalized attention of a private physician.

Why patients are switching to our model:

Zero Insurance Hurdles: Our all-cash model means no “surprise bills” weeks later. You get transparent, upfront pricing.

Urgent Care Speed: We are built for efficiency. Whether it’s a sudden illness or a long-overdue checkup, we get you in, treated, and back to your day.

Telehealth Convenience: Skip the drive. Our telehealth integration allows for “call-in” appointments that are even faster than a walk-in.

A Doctor You Actually Know: Unlike standard urgent care, you can establish a long-term relationship with a doctor who knows your history.

Don’t wait for the “next available” appointment three weeks from now.
Get the care you need today. You can call us directly or use our streamlined online scheduler to book your slot in seconds:

👉 Book Your Appointment Online Now

“An informed patient is a healthier patient.”

Shaan Kunwar DO

East County Internal Medicine

941-727-7771

If you’ve driven down Lakewood Ranch Boulevard lately, you’ve seen the cranes. The new five-story tower at Lakewood Ranch Medical Center is officially taking shape, and it’s an impressive sight.

As a physician in this community, I’m glad to see it. More beds and advanced specialty care are a win for Manatee County. But as the “big medicine” footprint grows, it’s worth asking: Where do you go when you aren’t in a crisis?

The “Tower” vs. The “Touch”

Hospital systems are designed for the “what.” What happened? What surgery is needed? What is the acute symptom? They are essential for emergencies and complex procedures.

But as an Osteopathic Physician (D.O.), my focus is on the “why” and the “who.”

In a solo practice, we aren’t building towers; we’re building relationships. Here is why “staying small” is actually better for your long-term health:

Continuity Over Complexity: In a massive system, you might see a different person every time. In a solo practice, I know your history, your lifestyle, and how your last vacation went. That context matters for your diagnosis.

The Osteopathic Edge: We look at the body as a connected unit. Sometimes that “back pain” isn’t a structural emergency for a hospital—it’s a lifestyle or alignment issue that we can address right here in the office.

Access, Not Algorithms: You shouldn’t have to navigate a call center to talk to your doctor.

Investing in Your “Before”

The best way to use that shiny new hospital tower? To never have to go there. Primary care is about the “before.” It’s about the preventative screenings, the stress management, and the metabolic health that keeps you active on the pickleball courts and off the patient floors.

We are lucky to have world-class facilities coming to Lakewood Ranch and Bradenton. But for the day-to-day work of staying healthy, there is no substitute for a doctor who actually knows your name.

“An informed patient is a healthier patient.”

— Shaan Kunwar, DO
East County Internal Medicine

941-727-7771