Diabetic foot

Your feet and diabetes

There is an old proverb that to look at someone's hygiene you should look at their feet. Nothing matches better with this proverb than diabetes and importance of foot care. It is a commonly ignored domain for which many people pay heavy price. India, being a temperate country ranks very high on infections and communicable diseases . 

Diabetes is the most common cause of limb amputation globally. Billions of dollars are spent annually at global level to treat this complication. It is well known fact that most of these amputations are preventable. 

It Is said that foot cleaning is as important as face cleaning in people with diabetes. Daily inspection of feet in mirror after feet cleaning in  the setting of diabetic neuropthy or vasculopathy is of utmost importance. Diabetic neuropthy which is a common microvascular complication of diabetes has various manifestations which includes burning feet and hands, tingling and numbness or loss of muscle power of limbs. As a result of this foot architecture changes so is pressure distribution which leads to development of corns or callosities. This compounded with poor immunity in diabetes leads sets the ground for development of ulcers which heals poorly and later on may develop into wet gangrene. Vasculopathy Which is commonly associated with neuropathy further delays the wound healing as blood supply is compromised. furthermore associated dydlpipidemia and smoking acts as additional risk factors for development of these foot complications.

These is urgent need to shift the focus from treatment part of diabetes and it's complications to preventive part to make bigger gains. It is sad to see that re amputation rate is very high in this population because of poor awareness about preventive strategies in this part of the world. There is a significant role of podiatrists  and diabetic foot surgeons in the management who along with  Endocrinologist or physicians should work to avoid amputations and preserve limbs.