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Diabetic Foot

Diabetes Mellitus is a global disease and a major health burden. There are many complications of diabetes. It affects kidneys, eyes, nerves and blood vessels, just to name few.

Diabetic foot disease is considered to be a serious complication often resulting in loss of lower limb or part of it. Diabetic foot includes callosities, non-healing ulcers with involvement of bones; and the most serious gangrene of toes or foot or even whole limb.

There are many contributory factors for diabetic foot problems. Neuropathy (involvement of peripheral nerves) and angiopathy (narrowing of blood vessels) are two most important factors. Neuropathy results in sensory loss, hence minor injuries go unnoticed and lead to major problems. Angiopathy results in decreased blood supply, the limb gets less oxygen and nourishment. Neuropathy also results in muscle power imbalance and deformities of toes, which in turn cause excessive pressure on certain parts of toes or foot. Neuropathy and angiopathy combined with toe or foot deformities are responsible for initiation of callosities and ulcers. These ulcers may get worse with severe infections. Angiopathy, if severe can end up in gangrene and amputation.

Self care of feet to prevent serious issues

Keep your diabetes under control.

Quit smoking.

Keep your feet as clean as your face.

Check sensation of toes. This can be done easily by any person at home touching your toes lightly and you feel with your eyes closed.

Check pulse at ankle and dorsum of foot (see diagram).

Check your feet for even a minor cut or callosity (hardening of skin).

Keep spaces between toes dry, as moisture leads to fungal infections.

Do not walk bare-footed even at home. You can keep separate pair of footwear / slippers at home.

Be very cautious when you start using new footwear. Minor abrasions can lead to major problems.

Your footwear must be comfortable and have broad toe box.

Cut toe nails in square shape (see diagram)

Check your feet for any deformities of toes.

Consult diabetic foot clinic for any sign of impending foot problem.

Be vigilant and save your limb.

Idrees Padela, Orthopaedic Surgeon
Idrees Padela, Orthopaedic Surgeon
Dr. Idrees Padela graduated from Dow Medical College in 1978, then acquired post-graduated diploma from Vienna, Austria and later on fellowship (FCPS) in orthopaedic surgery. He is currently practicing as consultant orthopaedic surgeon.

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