What is diabetic foot?
Diabetes results in foot related problems because of increased glucose levels in blood. These complications are collectively known as diabetic foot. Foot diseases affect about 6% of all diabetic patients and about 0.03% to 0.15% of people suffering from diabetic foot disease require amputation. There are two major conditions which constitute diabetic foot and cause serious symptoms – Diabetic Neuropathy and Peripheral Vascular Disease.
Diabetic Neuropathy is a complication in which uncontrolled prolonged diabetes causes damage to the nerves in the foot. This leads to loss of sensory functions in the foot, creating a numbness in the foot. As a result, people with diabetic feet cannot feel the extremities of their feet and are resistant to heat, cold or pain. A cut or sore to the foot may be left unnoticed and may lead to diabetic foot ulcers and in some cases even gangrene (tissue death due to blood shortage). The nerves to the muscles may be damaged extensively stunting the performance of muscles and causing distortions in alignment of the foot.
Peripheral Vascular Disease is a condition in which the blood flow to the feet is restricted. Fatty deposits can block blood vessels in extremities like hands and feet. This increases the time taken by a wound or an injury in these parts, to heal. In case of infections, there is a risk of developing diabetic foot ulcers or gangrene due to poor blood flow.
Diabetic foot ulcer:
Approximately 15 percent of diabetes patients are affected with this condition. Diabetic foot ulcer refers to an open sore or wound on the bottom of the foot. Diabetic foot ulcers can lead to lower extremity amputation.
Causes of a Diabetic Foot:
- Lack of sensory feelings in the feet can increase the risk of injuries to the foot. These painless wounds can develop into ulcers.
- Poor blood circulation makes it difficult for the wounds to heal. Along with numbness in foot, this can result in diabetic foot ulcers.
- Walking barefoot, wearing underfit shoes can also result in diabetic foot.
- Infections left untreated for a long time in foot can cause diabetic foot.
- Charcot arthropathy, which involves deterioration of bones, joints and soft tissues in ankles and feet can also implicate diabetic foot.
Diabetic Foot treatment:
The treatment of a diabetic foot depends on the extent of damage caused as a result of this complication. Diabetic foot treatment involves:
- The dead cells or the foreign bodies causing ulcers can be removed by a process called debridement. This can increase the healing capacity of the surrounding healthy tissue.
- Amputations ranging from single toe to leg below the knee can be employed to curb the development of gangrene.
- Antibiotics, antiplatelets or anti-clotting medications can be prescribed to treat diabetic foot ulcers in case of infections.
- Arterial bypass can be performed to regulate blood supply to the feet. Alternatively, tiny stents can also be inserted surgically to keep the blood vessels open.
- Topical dressings can be used as first aid to treat complications caused by diabetic foot.
Diabetic Foot care :
- The major step to care for diabetic foot is to fight diabetes itself. Healthy food habits, regular exercise and proper glycemic control can reduce the risk of diabetic foot.
- Diabetics should examine their feet frequently, or have someone examine it for them. Any changes, sores, blisters, calluses or injuries must be recognised as a sign of diabetic foot and a doctor must be consulted.
- The foot of a diabetic must be washed daily to prevent infections. Foot must be washed in warm water with mild soap. After washing, they must be wiped thoroughly with a towel. The space between the toes and fingers should be dried properly.
- The foot should be prevented from dryness by application of lotions suggested by doctors. Applying lotions between toes must be avoided to avoid the risk of infections.
- Nails should be trimmed in a specific manner to avoid diabetic foot. The nails should be cut straight across and not curved. Curved nail ends can bend inwards and cause an infection.
- Shoes of proper fit must be used by diabetics. Occulose footwear causes sweating in feet and can cause fungal infection in the feet. Special footwears are available for diabetic patients. Shoes and footwear which enclose the foot completely must be preferred over sandals or slippers which are more prone to external injuries. Closed pointed shoes and high heels which exert high pressure on the feet must also be avoided.
- Extreme temperatures should be avoided. Extreme heat or cold can damage the foot of a diabetic.
- Patients with a diabetic foot should ensure there is enough blood circulation in the feet. This can be done by putting the leg up while sitting, walking, wiggling the toes, massaging the foot and exercise.
- Smoking should be avoided at all costs as smoking interferes with the blood flow to the leg.
This is a very serious condition which hinders the normal livelihood of a diabetic. Prevention is better than cure. Proper care must be taken to avoid diabetic foot. Any problem noticed in relation with feet must be immediately informed to the doctor. It is advised to consult a podiatrist (doctor for feet) once in two to three months. Diabetics should keep their feet clean, monitor them regularly and wear proper footwear to totally avoid or at least reduce the intensity of the complications.