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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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FAQ’S

SAVE LEGS DIABETIC FOOT CLINIC  & WOUND CARE CENTRE

THE CENTER FOR COMPREHENSIVE CARE FOR LOWER LIMB( LEG) PROBLEMS

Introduction To Problems Of The Lower Limb

AREA OF NEGLECT

The foot has been a highly neglected area of the body . More so in India where walking bare feet is very common and protecting our feet is not usually considered necessary.

The sad reality however is that India also happens to be the diabetes capital of the world and the neglect of the feet can have devastating effects on the overall health of diabetics.

WHY ARE DIABETICS AT RISK FOR FOOT ULCER ?

Diabetes raises sugar levels in the blood. This causes blockage of the blood vessels of various parts of the body and of the nerves. So diabetics have no sensation(Neuropathy) in their legs & feet, the blood supply to the feet is reduced and they have a reduced capacity to fight infections.

WHAT ARE THE CONSEQUENCES OF ACQUIRING A FOOT INFECTION ?

The slightest injury like a pin prick, scratch etc can increase within hours to days without the patient realising it till, it is too late and this leads to amputations or in many cases to infection in the blood and death

WHY ARE FOOT ULCERS DIFFICULT TO TREAT ?

 For the same reasons, namely diabetic neuropathy, reduced blood supply and reduced capacity to fight infections. With neuropathy the patient has no feeling and is unable to feel pain. So he keeps walking on a injury or small wound or beginning infection, till the infection or injury becomes limb or life threatening. 

HOW IS THIS TREATMENT SPECIALIZED ?

This treatment is specialized because it has a comprehensive approach towards treatment and prevention of foot problems. Its like this, suppose you have a fever and you are diagnosed with malaria. Then till you treat the malaria, the fever is not going to subside. Similarly in case of the diabetic foot, in case you have a foot infection and a reduced blood supply, you will agree that simply giving antibiotics is not going to work as the antibiotic is not going to reach the affected area in adequate concentration. So till you increase the blood supply along with the antibiotic, the treatment cannot succeed. Similarly there are numerous situations in Diabetics where Multi Modality treatment is required to treat the condition.

WHY DO I NEED A DOPPLER AND WHEN WOULD I NEED AN ANGIOGRAM ?

A Color Doppler scan of the leg confirms the degree of damage to the blood vessels of the leg and what treatment would be appropriate in such a condition. An Angiogram of the lower limb is only contemplated in case the treatment protocol has to change. However nowadays with the advanced wound care techniques available, most patients with diabetic foot problems do not undergo vascular bypass or angioplasty, and therefore angiograms are done only in select cases.

 WHY GO FOR  SURGERY ,WHY NOT ONLY MEDICINES ?

The treatment is multipronged. I normally give medicines followed by surgery (if required). However in cases with pus in the leg, surgery is needed to remove the focus of infection. However surgery is not the be all and end all, it is followed by medical treatment and advanced wound care to heal the foot/leg.

Also all infections with open wounds are cultured for bacteria and other micro organisms and appropriate treatment given.

 WHAT IS ADVANCED WOUND CARE ?

Advanced Wound Care is the use of various modalities like Hyperbaric oxygen, Negative Pressure Wound Therapy, Advanced dressings like Silver films, colloids, Growth Factors etc to achieve closure of wounds.

It differs from traditional/conventional dressings – with gauze, iodine solutions(Betadine etc.), hydrogen peroxide – in that it takes into account all other conditions and does not damage healthy tissues and actually helps wounds to close. You might have heard of patients suffering from wounds for years on end.

Advanced Wound care modalities help in healing such wounds.

WHAT IS THE ROLE OF CUSTOMIZED FOOTWEAR ?

Customized diabetic footwear which is provided by the Save Legs Diabetic Foot Clinic, is made from advanced materials like Microcellular rubber, Plastazote, Silicon etc, with multi layer insoles and it also incorporates metatarsal bars, wingpads etc or any other modification needed so as to reduce the pressure on the affected part of the foot. Moulded insoles are also made for better reduction in pressure.