Diabetic Foot - An Untold Story

Diabetic foot disease is a debilitating complication of diabetes mellitus, ultimately affecting up to 50% of patients with both type 1 and 2 diabetes. Currently, this complication is still leading to significant loss of quality and years of life of the affected patient.
We have 72 million confirmed diabetes patients, so we need 144 million feet to look after. That’s a huge burden for society.
Furthermore, it represents at least 12-15% of the overall cost associated with diabetes and up to 40% in developing countries. Additionally, current treatments for diabetic foot disease are usually not as effective as they should be due to insufficient knowledge of its underlying mechanism and treatment tools because of inadequate interest. There are common FAQs about diabetic foot.
  • a. What is diabetic foot?
Any patient with diabetes who develops signs of burning pain, loss of sensation, recurrent nail infection or recurrent ulceration, or longstanding nonhealing wound in their feet is a patient of diabetic foot.
  • b. Why does it happen?
Because of longstanding diabetes, high blood glucose levels cause damage to nerves of sensation (sensory neuropathy) and vessels of lower limb blood circulation.
  • c. What are the common problems in diabetic foot?

Common problems in diabetic feet include repeated foot ulceration, longstanding nonhealing ulcers, burning feet, insensate feet, repeated nail infections, calf muscle pain while walking even a short distance, hard skin over the plantar aspect (corn), change of foot shape (charcot’s foot), and foot gangrene.

  • d. Are diabetic shoes of any special type or just the same as those available under doctors' sole footwear?
Actually, this is a very important aspect of diabetic foot management—these are better known as offloading shoes. Diabetic shoes are specialized shoes that provide a soft and smooth environment to the foot to prevent trauma. These shoes vary from patient to patient. According to the patient, the foot pressure sole is customized to distribute pressure equally and offload the high-pressure areas.
  • e. What is diabetic foot screening?
It is a group of tests used to study the status of foot damage due to diabetes. This test should be done every year in patients who have reached the diabetic age of 5. By doing this, we can predict future damage and take precautions to prevent it.
  • f. What precautions should we take in routine?
    • Clean your foot daily with soap
    • Moisturize your foot correctly at least twice daily, but maintain dryness between the toes.
    • Inspect your foot daily to see any redness or trauma.
    • Don’t use a blade to trim your nails – always use a good-quality nail cutter.
    • Stay barefoot at home and outside of home. Always use footwear.
    • Always use sole footwear with one larger size.
    • Always check shoes from the inside before wearing them for any foreign body.
  • g. What should we do if ulcers develop?
Always consult a trained diabetic foot / plastic surgeon. Don’t depend on dressing and antibiotics only. He will care for your wound accordingly. Sometimes, more extensive wounds may require reconstructive plastic surgery to heal.
Remember, prevention is better than cure. If you care for your foot, you will prevent it from amputation. Due to a lack of awareness among the general public, a very high number of foot amputations are performed. Unfortunately, these are preventable.