‘Every fifth diabetic who comes to me suffers from foot problem’

Foot care in diabetics is of paramount importance, because they don’t have sensations and experience severe numbness. And it goes unnoticed leading to infections, and untreated infections can lead to gangrene, which in turn may require amputation

Device designed at IIT Bombay to save over 100,000 diabetic foot amputations

When 50-year-old Shekhar Adajania (name changed) went for his routine sugar check-up to his physician, he ended up having a long chat with the doctor about how he had recently started hurting his heels while walking.

“What we must know is that anyone with diabetes needs to take care of their foot. More so because they don’t have sensations and experience severe numbness. Only after it is severe, do they realise its important,” said Dr Krishna Chaitanya, Consultant Vascular and Endovascular Surgeon at Columbia Asia Referral Hospital, Yeshwanthpur, Bengaluru.

Ask him, why the problem is so rampant, he quips. “In individuals suffering from diabetes, neuropathy which is peripheral nerve dysfunction can be combined with peripheral artery disease (PAD), leading to poor blood circulation in the extremities (diabetic angioplasty. Owing to which the individuals suffering from diabetes are unable to feel pain.”

If you have diabetes and your blood sugar levels are too high, it can damage your nerves or blood vessels. Nerve damage from diabetes can cause you to lose sensation in your feet. You may not feel a cut, a blister or a sore. Blood vessels’ damage means that the feet do not get enough blood and oxygen. Injuries to the foot can cause ulcers and infections and in severe cases it may even lead to amputation. It is harder for your foot to heal, if you do get a sore or infection.

“What one must know is, diabetics experience numbness. So naturally, when they have a wound, it is difficult to identify and more so, takes much longer to heal. Healing will only take place if the patients don’t put pressure on the foot. No amount of dressing will help unless they give complete rest to the foot,” said  Dr  Pradeep Gadge, Diabetologist, Gadge Diabetes Centre, Mumbai.

“Every fifth diabetic who comes to me has some or the other foot problem,” he said.

Adajania is currently getting treated for Peripheral neuropathy by Dr Chaitanya. Diabetes induced neuropathy causes the skin to dry up, and dry feet crack making it easy for the germs to enter the body. There are various other complications to this.  “Nerve damage can also lead to changes in the shape of the patients’ feet (Charcot foot), which makes previously comfortable shoes hard to walk in. This causes friction leading to calluses and bunions exposing skin to germs.”

He added, “Foot care in diabetics is of paramount importance as it goes unnoticed leading to infections, and untreated infections can lead to gangrene, which in turn may require amputation.”

That is why, doctor says, foot care is very important for diabetics. “I get at least two cases like Adajania each month. Foot care should be the prime consideration in diabetics, and is not difficult. Diabetics should regularly check their feet for any signs of damage.”

Look out for the below warning signals of foot damage:

  • Bruises
  • Cuts
  • Sores
  • Swelling
  • Grazes
  • Colour changes
  • Ulceration
  • Hard skin

Having mentioned the warning signs let’s now look at the daily foot care routine which should ideally be followed by diabetics:

  • Check your feet every day
  • Wash your feet every day
  • Keep the skin soft and smooth
  • Smooth corns and calluses gently
  • If possible, trim your toenails regularly. If you cannot, ask a foot doctor (podiatrist) to trim them for you.
  • Wear shoes and socks at all times

Following a good foot care regimen will go a long way in keeping your feet healthy. This should include:

  • Periodic medical check-ups including foot check-ups and monitoring your ABCs (A1c, blood pressure, and cholesterol)
  • Monitoring sugar levels daily
  • Exercising every day, and
  • Eating a balanced diet

Always avoid taking the following risks:

  • Diabetics should not use over the counter medications for treating warts or corns on the feet.
  • Never walk around the garden or outside barefoot, wear perfect fitting shoes for indoors and outdoors.
  • Regularly use heating pads or keep the feet in a bucket of warm water.
  • Avoid smoking as it reduces the circulation of blood and healing process of wounds drastically increases.
  • Never cross the legs while sitting for long period of time.

If any of the above are noticed a doctor should be consulted immediately, as it may lead to serious health complications.