People with diabetes can develop a variety of problems - including foot problems. Even ordinary problems can rapidly worsen & lead to serious complications. If this happens to the feet, it may result in deformity, disability or even amputation. Foot problems are the leading causes of hospitalisation in Diabetes Mellitus, accounting for expenditure of crores of rupees annually & serious morbidity & mortality. It has been established that 15% of all diabetics will develop a serious foot problem at some time or the other which can threaten the limb or the life of the individual. The average hospital stay for a patient with a diabetic foot is 1 month & roughly 50% may need hospitalisation for 3 months or more. Lower limb amputations in patients with Diabetes account for 50% of all non traumatic amputations. The rate of lower limb amputations in patients with DM is 40 times higher than in people without DM. The incidence of amputation of the other foot within three years is also very high.

This sounds like very bad and tragic news for Diabetics. But the good news is that most of these problems can be prevented through regular visits to the doctor and proper foot care.

• Nerves get numb, so one often fails to appreciate injury as there is no pain.The sense of temperature is also lost, so one might not appreciate hot things over the feet, e.g hot water, hot tiles while walking bare feet.
• Feet get deformed, altering the mechanics of weight bearing that nature has so beautifully created.This exposes areas of feet to abnormally high pressures which results in breakdown of skin.
• One sweats less in the feet.So skin of the feet 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 wounds.
• Adding to the problem is the fact that 20% of diabetic foot problems have narrowed or blocked blood vessels in their feet. This further impairs wound healing as blood flow is required to heal any wound.

• Evaluation by a Vascular Surgeon with a vast experience in managing diabetic foot problems and specifically, problems in the blood vessels to your legs.
• Evaluation by a highly qualified Endocrinologist with specific experience in managing this problem to tailor your diabetic medication to your needs.
• A computerised foot profile including a Doppler evaluation, biothesiometry and Paedopodogram.
• Evaluation by a Rehabilitation specialist with an expertise in foot rehabilitation, to suggest the most appropriate footwear for you.
• Dressing of your wound by a nurse specifically trained in Diabetic foot care.

In addition, if deemed necessary, you can avail the services of an internationally renowned faculty to open out your blood vessels, along with an appropriate footwear made in-house, at a reasonable cost.

• Clean the wound with soap and luke warm water.
• Cover the wound with sterile gauze.
• Check your blood sugar.
• Use plastic bag to cover the foot. Contact your doctor immediately &/or seek an appointment with the Diabetic Foot Clinic.

PATIENTS CO-OPERATION AND PARTICIPATION IN THE MANAGEMENT OF FOOT PROBLEM IS IMPORTANT FOR SUCCESS OF THE TREATMENT IN DIABETES.