People with diabetes can develop many complications, including several foot problems. Even ordinary complaints can rapidly worsen and lead to serious complications. If this happens to the feet, it may result in deformity, disability or even amputation.
It has been established that 15% of all diabetics will develop a serious foot problem at some time or the other which can threaten the limb or the life of the individual. The average hospital stay for a patient with a diabetic foot is one month, and roughly 50% may need hospitalisation for three months or more.
Lower limb amputations in diabetic patients account for 50% of all non traumatic amputations. The rate of lower limb amputations in patients with Diabetes Mellitus (DM) is 40 times higher than in people without DM. The incidence of amputation of the other foot within three years is also very high.
However, the good news is that with regular visits to the doctor and proper foot care, most of these problems can be prevented
Why is the foot affected in diabetes?
Foot supports the body
Absorbs impact of locomotion
Normally, man walks 10,000 steps daily
In a 70 kg person, >120 tons of pressure is borne by the feet per mile of walking
Each step puts 150 lbs/sq inch pressure on the soles
You will, thus, realise the tremendous impact of forces and stress that our feet bears.
Hot water, steam, sunburn, electric heating pads and hot water bottles
Cold and frostbite
Tight shoes, stockings, sandal/Hawaii chappals, straps or nails in shoes that can cause pressure on foot
Chemicals and other strong medicinal applications
Wet, moist feet and webs
Careless cutting of nails
Bunions, calluses and corns
Tobacco intake in any form like cigarettes, beedis, gutka, etc.
What Happens To The Feet In Diabetes?
Usually in diabetics the nerves get numb, so one often fails to notice injury as there is no pain felt. The sense of temperature is also lost, therefore, one might not feel hot water or hot tiles while walking bare feet
Feet get deformed, altering the mechanics of weight bearing, thus, exposing the areas of the feet to abnormally high pressures which results in breakdown of the skin
One sweats less in the feet, so the foot skin becomes rough and dry, leading to cracks, which allow bacteria to enter and cause infection
The ability to fight infection is reduced in Diabetes as the body’s defense mechanism is weakened. Wound healing mechanisms are also affected, leading to prolonged time in healing of the wounds
Adding to the problem is the fact that 20% of diabetics with foot problems have narrowed or blocked blood vessels in their feet. This further impairs the healing process as adequate blood flow is required for healing any wound
You could be having diabetic foot problems, if you get burning, shock like, numbness or pricking sensation in your feet.
Taking care of your feet
Apply heat to the feet
Soak the feet in water for too long
Cut your own nails, only file them
Wear ill fitting shoes
Assume that sensation and circulation is normal in your feet
Use strong or irritative medicines on your feet
Permit calluses or corns to develop
Perform ‘Bathroom Surgery’ on your feet
Keep your feet too moist or too dry
Checklist For Good Shoes
Shoes should cover and protect feet
Avoid pointed, high heels shoes
Know your foot size
Go for shoe shopping in the evening
Buy half a size larger than the perfect fit
Break in new shoes gradually to avoid blisters
Use clean, dry seamless socks/ stockings of right size
Wear comfortable footwear at home. Keep a separate pair of footwear for outside use
What services are offered by our diabetic foot clinic?
Evaluation by a Vascular Surgeon with a vast experience in managing diabetic foot problems and specifically, problems in the blood vessels of your legs
Evaluation by a highly qualified Endocrinologist with specific experience in managing this problem to tailor your diabetic medication as per your requirements
Evaluation by a Rehabilitation Specialist with a world renowned expertise in foot rehabilitation to suggest the most appropriate footwear for you
A computerised foot profile including a Doppler Evaluation, Biothesiometry and Paedopodogram
Dressing of your wound by a nurse specifically trained in Diabetic Foot Care
The Diabetic Foot Package at Kokilaben Hospital provides all these services under one roof. In addition, if necessary, you can also avail the services of an internationally renowned faculty to open out your blood vessels, along with appropriate footwear made in-house at a reasonable cost.
What should i do if i am a diabetic with foot problem?
Clean the wound with dilute Savlon/Dettol
Cover the wound with sterile gauze
Check your blood sugar
Make sure your affected foot does not get wet. Use plastic bag to cover the foot
Contact your doctor immediately and/or seek an appointment with the Diabetic Foot Clinic
Patient’s co-operation and participation in the management of foot problem is important for the success of the treatment in diabetes.
Please note that you cannot schedule an appointment with the Consultants on the same day through an email. For any emergency, call: 91-22-30919191. If this is an urgent request or please call us at:+91-22-3069-6969 or SMS 'KDAH' to 55454
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