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States » East


Diabetic Foot Syndrome- the less spoken condition among Diabetics

Kolkata, Nov 13 (UNI) Diabetic Foot Syndrome- the less spoken condition among Diabetics
Studies - have established India as the home to a majority of diabetics across the globe and by
2030; India will have the largest number of diabetic patients.
It is a commonly known fact that prolonged periods of high blood sugar comes with its own set of comorbidities but there is very limited awareness that diabetic foot syndrome is one of the most common diabetic complications found in India.
“Associated with advancing age, low socio-economic status, sedentary physical activity and longer duration of DM, this condition is characterized by numbness or tingling sensation, blisters or other
wounds without pain, skin discoloration, skin temperature changes, foot deformities, wounds and foot
ulcers often with super imposed infection,” explains Dr. Ashwin Chowdhury, Consultant Orthopedic
Surgeon at Fortis Hospital Anandapur.
“People with diabetic feet can develop complications such callosities, corns, bunions, ingrown toe nails, non-healing foot ulcers, infections, including bone infections and abscesses, gangrene, Charcot's Foot (fractures or dislocations),” he added.
As research suggests, out of 62 million diabetics in India, 25% develop Diabetic Foot Ulcers (DFU), of which 50% become infected, requiring hospitalization while 20% need amputation.
DFUs contribute to approximately 80% of all non-traumatic amputations in India, annually. Patients with a history of DFU have 40% higher 10-year death-rate, than those without.
In spite of the conditions being pretty common among diabetics, they can be prevented by keeping the feet healthy.
Dr. Chowdhury suggests the following common methods to avoid occurrence of foot problems due to diabetes: • Daily examination of feet to check for any changes or injuries. • Washing feet daily with warm water and a mild soap to prevent infections. Gently pat your feet dry and apply a moisturizing cream or lotion. • Wearing protective footwear. • Regular exercise to promote blood flow to the feet. • Trimming nails carefully and cutting them straight across and keeping them short and thereby preventing ingrown toe nails. • Protecting the feet from extreme temperatures. • Get feet checked regularly by a doctor to prevent infections, amputations, deformities.
Diabetics with peripheral neuropathy, vascular disease or deformity should be examined by an orthopedic foot and ankle specialist at least every one to two months. • Controlling blood sugar • Avoiding smoking. • Proper footwear is an important part of an overall treatment program for people with diabetes, even for those in the earliest stages of the disease. They should avoid walking
barefoot or in sandals or thongs.
Footwear for people with diabetes should be able to relieve areas of excessive pressure, reduce shock and shear, and yet accommodate, stabilize and support deformities and limit motion of joints.
One should choose shoes carefully and buy shoes that are comfortable by checking how shoe fits in width, length, back, bottom of heel and sole.
Try to avoid pointed-toe styles and high heels and try to get shoes made with leather upper material and deep toe boxes. It is a good idea to wear new shoes for only two hours or less at a time. One should inspect the inside of each shoe before putting it on and not lace your shoes too tightly or loosely.
• Diabetics should try to wear clean, dry socks every day and avoid socks with holes or wrinkles and consider using compression stockings if their feet tend to swell. Additional orthotics such as foot pads, shoe inserts and ankle braces may be needed to correct foot and ankle problems non-surgically. •
People who have diabetes should see a doctor regularly as part of their care.
However, they should seek immediate medical attention if they notice changes in foot skin color,
swelling of the foot or ankle, temperature changes in the feet, persistent sores on the feet, pain or tingling in the feet or ankles, ingrown toenails, athlete's foot or other fungal infections, dry and cracked skin on the heels or signs of infection.
Foot infections, in persons with diabetes, become more severe and take longer to cure than do
equivalent infections in persons without diabetes.
As explained by the foot and ankle specialist at Fortis, “Treatment for diabetic foot problems varies according to the severity of the condition."
"A range of surgical and nonsurgical options is available. Nonsurgical options are normally the first method of treatment for diabetic foot problems. Some of these include keeping wounds clean and dressed, antibiotics to combat infection, immobilization devices, such as a cast boot or total contact cast, close observation of gangrene toes until self-amputation occurs, when the toes fall off due to lack of blood flow."
"When nonsurgical treatment fails to heal diabetic foot problems, surgery may be considered.
Surgical treatment options include removal of decaying or dead tissue, amputation, varying from toe or part of the foot to amputation of the leg below the knee, or above the knee in some cases, surgical
stabilization of Charcot's Foot. Some patients with severe foot ulcers and peripheral vascular disease
(poor circulation) may require procedures to restore blood flow to the foot such as arterial bypass for
peripheral vascular disease, or endovascular surgery with placement of stents.”
Speaking on the newer approaches being evaluated for the treatment of diabetic foot complications, Dr. Chowdhury explained, “New options include synthetic wound dressings, skin grown in a laboratory, substances that stimulate healing and support the growth of infection-fighting cells,
electrical stimulation, and exposure to elevated oxygen levels.”
For people with diabetes, foot complications are an ever-present risk. However, it is possible to
design a plan for keeping the feet as healthy as possible.
It is important to learn as much as possible about diabetic foot care and to take an active role in medical decisions and care. While routine medical exams are important, everyday foot care plays the biggest role in preventing foot complications before the concerns set off.
UNI XC AKM
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