Health Blog


Foot care in Diabetes

Published on 2017-03-21 07:03:44

It was just yet another small wound for Manjunatha before he ignored it while encountering a flooded Chennai street. Little had known that the small wound in his right foot caused by a small submerged rock would result in amputation of his leg. The 50-year old businessman became busy in his day to day affairs ignoring the small wound. To his surprise, instead of healing, the wound got infected and became severe in some days. It did not take much time for his foot to become black with weeping pus. It became too late to reach the doctor who suggested surgery urgently. In the process they had to amputate Manajunatha’s leg. But the infection and damage was so severe that Manajunatha was not responding to the treatment. Gradually the other leg was also infected and had to be amputated

Manjunatha’s story is a reality check for those who are not ready to realize how unrestrained diabetes can be proved with number of health complications such as heart problems, kidney injury, loss of sight, and cancers that ultimately lead to amputation. Diabetes condition must be treated carefully otherwise it would result in a horrifying damage to human being like death. .

Alarmingly, Manjunatha’s situation is not unique. There are millions of people who have been suffering from the fatal epidemic. According to a leading newspaper in India, 44 lakh Indians aged 20 to 70 are unaware of their diabetes which can lead them to heart attack, stroke, amputations, nerve damage, blindness and kidney disease. According to a study, the diabetes epidemic had killed 10 lakh people in India in 2011 and surprisingly it affected 34 million rural people and 28 million affluent urban. This clearly suggests that lack of awareness, self care and medication is the reason behind this. According to a study published in Diabetologia, a journal on diabetes, patients with Diabetic Foot Ulcer (DFU) have a greater all-cause death risk compared to the patients without a history of DFU. Based on an assessment of 619 events of all-cause mortality, an additional 58 deaths per 1,000 each year with diabetic foot ulcer are reported.

Diabetic wounds: causes and effects

Diabetes, Diabetic Foot Care, Foot Care

A small wound on body, especially, in the extremities (hands and legs) during diabetes can be proved dangerous and fatal. It is hardly curable and takes longer time for healing. Having high level of blood sugar for longer period makes the bodily functioning improper such a reduced blood flow and damaged nerves especially in the extremities. The patients with diabetes would likely to develop infection to a small external wound which is ignored, unnoticed, or delayed in treatment. Gradually the wounds get infected and increase in size with chronic pain or completely painless; signs of inflammation, heat, pain and loss of function; signs of infection such as pus drainage, bad odour and dead tissue. The affected areas also develop numbness and dullness, chills of limb-threatening or life-threatening infection. Hence, in diabetes, special care must be given to legs since legs are prone to external wounds and wound of negligible size must not be ignored.

Foot care in Diabetes

According to Dr. Srujal Shah, vascular surgeon, foot ulcers are sores or wounds on the foot and are often a strong indicator of advanced diabetes. Most frequently, these wounds occur on the bottom of the foot under pressure points (such as the ball of the foot) and on the toes. If the there are wound in these areas, then it worsen the situation.

"Up to 25% of patients with diabetes develop a foot ulcer. More than half of all foot ulcers become infected, requiring hospitalization and 20% of infections result in amputation. Diabetes contributes approximately 80% of all non-traumatic amputations performed every year. After a major amputation, 50% of people will have another other limb amputated in two years. People with a history of a diabetic foot ulcer have a 40% greater 10-year death rate than people with diabetes alone. Diabetic foot ulcers double death rate and heart attack risk while increasing risk for stroke by 40%," said cardiologist Dr Hemang Baxi.

It is a moral obligation of diabetics to take care of their feet. Walking regularly with a pair of comfortable shoes solves half of the problems. The physical activity while walking controls diabetes and takes care of the feet due to the loose and comfortable shoes. They must strictly avoid using extreme tight and pointed shoes, slippers, and walking bare foot. They must use cosy and cleaned shocks. They must avoid extremes of temperatures and direct heat or cold to the feet. They must get regular checkups with the doctor, who will examine the legs for a proper pulse and blood supply. In case of doubts, a Color Doppler test is suggested.

Diabetics must inspect their feet every day, and in case get a foot injury, they must seek care early. They must strictly and judiciously follow the instructions provided by the doctor and obey do's and don'ts of foot care.

With adequate carefulness, diabetic people can prevent serious foot problem by taking care of their feet every day.

Prevention

Since people with diabetes are prone to foot problems, a foot care specialist must be hired in their health care team. They must perform an annual complete foot exam by the healthcare provider and even more frequently if the problem is more intense. They must call or see doctors to check whether have cuts or breaks in the skin, or have an ingrown nail. They must very vigilant to observe any change in colour, shape, or sensitivity in legs. The corns or calluses must be trimmed for them by the health care provider. They must trim toenails safely.

By following some simple tips, diabetic can take care of their feet.

 

Consultation with diabetic specialist


One must give importance to minimise the risk of diabetes by finding specialist for comprehensive diabetes and cardio metabolic care. Strictly one must learn how to keep blood sugar levels under control. Specialists can provide instruction, activities, food, and additional instructions to control diabetes.


Attention to feet is as important as face


Utmost care and attention must be given to diabetic feet every day. It must be lifetime care process that should be followed regularly. The patients and their family members must check the feet regularly for cuts, red spots, blisters and swelling. The patient may use a mirror to check the feet if the patient has problem in bending.

Relaxation for feet in warm water

 

The diabetic feet must be relaxed and given more comfort. One must wash the diabetic feet in warm water every day without fail. The entire feet and especially the gaps between the two toes must be cleaned properly with warm water. Hot water must be strictly avoided as the diabetic feet are sensitive and prone to damages. They must be dried very well especially gaps between two toes with a clean and dry cloth.
 

Moisturize the diabetic feet


The diabetic feet must be moisturized properly to avoid dryness and dullness of the feet and toes. After a thorough discussion with the foot care specialist and according to the advice of the doctors, a specialised skin care lotion must be applied on the top and bottom of the feet. The gaps between the toes must be avoided strictly.


Smoothness for Diabetic feet


The diabetic feet must be smooth to avoid dryness, and external injuries and rashes. The diabetics must pay more attention to smoothen the feet. With a proper consultation with the doctor they try to make use specialised objects to smoothen the skin. If required, they can use pumice stone to smoothen calluses and corns in the feet. But the use sharp objects must be strictly avoided.

Taking care of toenails. Trimming of the toenails on regular basis is required


Grown up and long nails are prone to accident and foot injuries. As a diabetic, one must strictly avoid long nails. Most of the cases long nails accumulate dirt which can cause swelling and infection in the nails. The patients must trim their nails regularly before they grow longer. A thorough and regular trimming will keep the nails clean and free from dirt.

Comfortable walk


The diabetic feet must not be pressurised rather must be comfortable every time whether walking or resting. Utmost care must be given while walking to avoid any painful walking experience. While walking, use comfortable and pair of shoes those give smoothness and comfort to feet. Use of cleaned and comfortable shocks makes walking experience more conformable. Diabetics must use cleaned and dirt free shoes. They must check the shoes very carefully about any objects and small stones inside it before wearing.


Good blood circulation keeps feet happy

 

Diabetic limbs especially the extremities experience less blood flow and damaged nerves. These areas must be given more smoothness for better blood circulation. While sitting for long periods of time, they must not be crossed rather must be relaxed. The diabetics must put their feet up while sitting. A little exercise for the toes and ankles can help a lot. Movement of ankles up and down, wiggling of toes about 5 minutes in a day for 2-3 times helps a lot.

 

Diabetes has been considered as a fatal epidemic which needs to be taken seriously. Proper self care, attention can help minimise the severity. Special care must be given to feet as a small wound in the feet can create catastrophic concerns and even can be fatal.