Diabetic Foot Clinic

• 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.

Foot Foes

• 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
• Adhesive tape
• Wet, moist feet and webs
• Careless cutting of nails
• Vigorous rubbing/massage
• Bunions, calluses and corns
• Walking barefoot
• Tobacco intake in any form like cigarettes, beedis, gutka, etc.

• 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.

Never

• Apply heat to the feet
• Soak the feet in water for too long
• Cut your own nails, only file them
• Wear ill fitting shoes
• Walk barefoot
• 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

• 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.

• 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.