Tag Archives: #diabeticfoot

Gangrene with Renal Disease & Diabetes

This was a patient referred from Saudi Arabia.

Chronic smoker, diabetic, peripheral arterial disease with end stage renal disease on hemodialysis thrice weekly. Patient had critical limb ischaemia and presented to us with gangrene of the left side first toe with  infection spreading to the proximal part of the foot with draining wounds.

Patient was operated, advanced wound care instituted and was also started on Hyper Baric Oxygen Therapy. Patient healed completely. Thereby the foot was saved and patient suffered loss of only one toe which was already gangrenous at presentation.

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Charcot Foot with Fracture

This is a case of diabetic charcot foot with fractured calcaneum. Patient had been to multiple hospitals before coming to us. Patient was asked to walk on the fractured calcaneum. No one bothered to take an x ray and only after we did an X ray we realised the patient had a fracture of the calcaneum. Patient came with a through and through wound on the plantar aspect of the foot, involving the heel. Calcaneum was evident on probing. We did advanced wound management and as the x ray show, the fractured calcaneum healed and patient was mobilised in customised footwear. 
 

Diabetic Foot – Causes & Symptoms

Diabetic Foot – Causes, Symptoms and Treatment

What is diabetes?

Diabetes is a disease that occurs when the blood sugar/glucose levels of the body are too high. Glucose is what gives you energy and is distributed to your cells with the help of a hormone called Insulin that is produced by the pancreas.  Sometimes, the body may fail to produce enough insulin or use it well to break down the glucose properly.  This causes the glucose to remain in the body and doesn’t reach your cells. Excess glucose levels in the body can cause diabetes.

Types of Diabetes

Diabetes is usually segregated into Type 1 Diabetes, Type 2 Diabetes and Gestational Diabetes

Type 1 diabetes

  • genetic condition that is usually detected early on in life

Type 2 diabetes

  • usually associated with unhealthy diets and lifestyles and may develop over time

Gestational diabetes

  • Can develop in some women during pregnancy, most likely to be temporary and last only till child birth
  • Women who experience gestational diabetes are prone to developing type 2 diabetes later on in life

 

How does diabetes affect the foot?

 

Diabetes can commonly affect the foot due to nerve damage. A large number of people with diabetes face some sort of nerve damage, that can lead to diabetic foot problems and complications. This is often referred to as ‘diabetic neuropathy” and is common among people with diabetes. Diabetic neuropathy may cause tingling sensations, pain and even loss of feeling in the feet.

Loss of feeling may be dangerous as a person may not realize when they get wounded on the foot. An open cut/blister or wound may lead to infection and inflammation of the foot. If not treated soon enough, it can contribute to complications like gangrene and other diabetic foot problems. The infection may also not heal properly due to loss of blood circulation in the feet.

When should you consult a doctor?

If your wound does not seem to heal within a few days or if you notice it getting worse, consult a doctor as soon as possible.

Common symptoms of diabetic foot problems include:

  • Swelling/inflammation or redness of the foot
  • Cuts/bruises/blisters/ulcers that don’t seem to heal
  • Calluses with dried blood inside
  • Blackening of a wound or foot infection with bad smell
  • Painful skin on the feet

How to prevent foot infections due to diabetes

  • Wash your feet everyday with warm water and soap (avoid soaking as it can dry up the skin)
  • Check your feet once a day for cuts/ulcers/blisters
  • Keep your toenails clean and cut
  • In the case of corns, get them removed safely by your doctor
  • Get your feet checked during your health checkups
  • Wear full-length socks to protect your feet

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Charcot foot with Osteomyelitis

This is a Charcot foot in a diabetic. Patient had a long standing draining wound on the foot. Xray showed a fracture of the base of the fifth metatarsal along with osteomyelitis.

Two months after surgery the wound had closed completely

An Xray taken six months after treatment was started, showed complete resolution of the osteomyelitis and the fracture of the base of the fifth metatarsal had healed.

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Diabetic Charcot Foot

This is the case of an infected Charcot foot, with multiple areas of lysis and osteomyelitis of the tarsals and first metatarsal as is evident from the xray. Patient also had calcification of peripheral arteries. He came from one of the gulf countries where he had been under treatment since 5-6 months and was then advised forefoot/below knee amputation.
Patient was anatomically debrided, rheologics and other supportive treatment started. Offloading was with the help of a Patellar Tendon Bearing brace.
12 months later the foot had completely healed, lytic areas no longer evident on X ray. Patient was mobilized in a pressure reducing footwear.
The save legs diabetic foot clinic hyderabad India routinely treats patients with gangrene, diabetic foot infection, charcot foot, diabetic foot ulcers. Its comprehensive approach to diabetic foot problems has made it a referral centre for diabetic foot treatment with many patients coming from various states and outside the country too.

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