Diabetes causes multiple complications because of the high level of glucose in the blood. One of them is diabetic neuropathy, which largely affects nerves in feet, which may result in ulceration on the feet. Non-healing ulcers can lead to amputation. So it is important to detect ulceration process before it starts and prevent it.
A Biomedical Engineering and Technology (Incubation) Center (BETiC) team at IIT Bombay has developed a semi-automatic non-invasive device for screening a diabetic foot condition. It detects the stiffness of the tissues on the sole of feet and categorises the condition of the foot in green, yellow and red risk zones. The clinicians can warn patients susceptible to diabetic foot ulceration in advance, potentially saving them from an amputation. Chetan Pakhare, who developed the device at BETiC, teamed up with Dr Rajani Mullerpatan, Director, Physiotherapy, in Mahatma Gandhi Mission Institute of Health Sciences (MGMIHS), Navi Mumbai for clinical trials of the device.
Explaining the idea behind the device, Chetan said “India has gained the dubious distinction of being the diabetic capital of the world. About 20 to 25 per cent of patients with diabetes develop foot ulcers. And diabetic foot ulcer precedes almost 85 per cent of amputation.
This device will help doctors to predict foot ulceration and suggest proper foot care methods to patients to avoid such amputations. Unfortunately, the ratio of diabetologists to the number of diabetic patients is too low in India. This device can fill the gap since it can be used by even GPs to screen and monitor diabetic foot patients.”
Diabetic neuropathy is assessed using various parameters such as sensation in a foot, temperature distribution and blood circulation. “The current devices in the market do not check the stiffness of the foot, which is a better indicator. A device to assess the stiffness of tissues on the sole of feet was missing. The diabetic foot screening device developed at BETiC overcomes this limitation and provides an affordable and reliable method that is easy-to-use by the doctors,” said Dr Rajani Mullerpatan who had floated the idea and has been clinically guiding the project.
The prevalence of diabetes has been increasing rapidly worldwide, especially, in low- and middle-income countries like India. According to a WHO study done in 2015, 8.7 per cent of the Indian population (over 69 million) is living with diabetes. In more than 36 million people it remained undiagnosed. The diabetic foot condition adversely affects the livelihood of the patients. “In most of the cases, doctors advise such patients not to walk and to use a wheelchair. It is a hidden form of disability which adversely affects their productivity and livelihood. So it is important to identify and stop the condition before it gets out of hand (or rather the leg),” said Chetan Pakhare.
According to Dr Rajani, the device will be most valuable in the rural healthcare system as the number of diabetic patients in rural India is alarmingly increasing. “We need to deploy this device at every primary healthcare center in rural parts and train rural health care workers to use it,” she said.
Dr Arun Bal who is a senior Diabetic Foot Surgeon said, “I have seen this device and it is going to be extremely useful to doctors. The team had developed an essential device. It will help doctors to evaluate the strength of the tissues in diabetic foot. It will be useful in preventing amputation.”
Dr Tushar Rege, Diabetic Foot Surgeon said, “Most of the times diabetic patients are not aware of neuropathy and its consequences. So the ulceration at the pressure points can lead to amputation. So this device will help detect the rigidity and it will help in preventing ulceration. It will also help doctors to counsel patients about preventive measures in order to avoid ulceration.”