Best treatment for Care of Diabetic Foot in India

Diabetic foot is a condition in which a patient with prolonged diabetes and uncontrolled blood sugar levels have an infected wound over the leg and foot region. There could be accompanying swelling of the area with redness or pain.

Diabetic foot can also present as generalized swelling with blisters over the whole leg as the main sole complaint of the patient. Most of them have a history of fever and decreased sensation of the limb.

The annual incidence of diabetic foot ulcers is about 2% - 5% in the general population. If blood sugar levels stay high for a long period in diabetics, it can damage the nerves and blood vessels of the foot.

Diabetic patients are more prone to ulcers in the foot due to:

• Neuropathy – Diabetic patients have decreased sensations in the foot, due to damage to nerves by sorbitol (sugar). There is-
  • loss of touch, pain and temperature sensation in the sole region of the foot,
  • a sensation like walking on sand
  • loss of curvature of the foot.

  Sometimes due to peripheral nerve damage, you lose the sensation in your feet. You stop feeling any soreness, cut, or blister. These minor injuries may also remain undiscovered for a long time which further causes infection. Often the patient is unaware of any trauma to the skin and the wound progresses deeper and deeper. These patients can be relieved by using specialized footwear, which avoids pressure points.

• Resistance to infection is decreased - in patients with diabetic mellitus (DM) and immunity is decreased.
• Atherosclerosis/Arteriopathy - leads to narrowing or blockage of the lumen of the blood vessel, thereby decreasing blood flow and oxygen supply to the foot due to which the ulcers don't heal.

These factors - peripheral nerve damage, infection, and arterial blockade alone or in combination increase the chances of the occurrence of ulcers in the foot region of diabetics. Sometimes the condition becomes so serious that it may also lead to Amputation of the foot or leg.

Risk factors for diabetic foot ulcer:

• Male above 50 years
• Diabetes of > 10years
• Uncontrolled blood sugar levels
• Peripheral neuropathy
• Abnormal structure of foot
• Peripheral vascular disease (narrowing of blood vessels)-20 times higher in diabetics.
• Smoking and hypertension
• Increased levels of lipid (cholesterol)

So, patients need to assess and CHECK their feet daily in case of unnoticed injury to the foot and should consult a plastic surgeon to stop the further progression of the injury. But due to a lack of knowledge about the proper management of the disease and less awareness about consulting the right person at the right time, patients think that it might heal with medications only and often present with late complications and sometimes in a stage where limb salvage is not possible and even life is at risk. So, the awareness to consult a Plastic Surgeon and get proper management is very important in the diabetic foot.

Care of Diabetic foot Cellulitis/Abscess/Necrotising Fasciitis Surgery on diabetic Foot