Did you know that that 15 % of all diabetic patients get foot ulcers? Among them, 1 % require a higher-level amputation. Learn how to take care of your feet and prevent diabetic ulcers from forming.
A majority of the diabetic patients admitted to various hospitals come for the management of lower limb and foot infections as well as gangrene. Most of these happen due to a poor management of the problem and also due to a general lack of awareness among the public about the repercussions of these problems. An amputation of a limb is a life-altering disability. Often, this procedure is undergone by the sole earning member of the family, and this causes a financial crisis within the household.
Ten Points for the Prevention of Diabetic Foot Problems:
Why Should Amputations Be Avoided in a Diabetic Patient?
In diabetes, the blood vessels are the major target organs. So, all the organs in the body subsequently get involved. By the time the lower limb has a peripheral obstructive vascular disease, nearly all the organs are already affected by ischemia. The blood vessels of the heart are also greatly damaged. Many studies have shown that in a diabetic patient, walking, even with the best of a prosthesis, strains the heart by over 15%. Many studies have proven that in a diabetic patient who walks routinely with a below-knee prosthesis, there is a 50 % mortality rate in five years due to cardiac failure, and with an above-knee prosthesis, there is a 50 % mortality rate in three years due to cardiac failure. Thus, the primary reason we try to prevent major amputations in diabetic patients is not to improve the quality of life but to increase their longevity.
In a diabetic patient, one of the significant tissue changes is due to ‘nonenzymatic glycation' which affects all the soft tissues in the patient’s body. This, in turn, immensely lowers the cell-mediated immunity. In such a case, if a lower limb infection occurs, and it is improperly managed, the disease can spread like 'wildfire,' and can cause a loss of limb or even life.
The surgical treatment of lower limb infections in people with diabetes is managed with proper debridement. Once the infected areas are thoroughly debrided, the tissue is sent for bacterial and fungal culture and sensitivity. The patient is then administered culture-specific antibiotics and if required, anti-fungal medication. An appropriate wound dressing, strict offloading of the involved limb, and supportive therapy are necessary.
Reconstructive and Corrective Foot and Ankle Surgeries:
Another serious foot and ankle problem which can happen in an uninformed diabetic is osteoarthropathy of the foot and ankle bones. This is also called the ‘Charcot foot.' In this condition, the foot bones become soft, and lose their density, due to the autonomic neuropathy occurring in diabetes. As an analogy, if we were to place a wooden board dipped in water for over six weeks, imagine how it would be. Soft, sodden, spongy, and friable. Is that right? So also in Charcot foot syndrome. When a patient walks with these soft feet bones, they develop fractures, erosion, and severe destruction. When detected early, they can be managed conservatively. Whereas in untreated cases, the foot and ankle bones become severely destroyed, and usually the patient is subjected to a below-knee amputation. In specialized centers though, the foot can be salvaged by doing a 'reconstructive foot and ankle surgery' with excellent results.
The diabetic foot and lower limb diseases that we commonly come across include extensive lower limb necrotizing fasciitis, diabetic foot infections including gangrene with peripheral vascular disease, and Charcot’s foot, some with a marked destruction of the foot and ankle bones and grossly deformed toes and feet. These deformed feet and toes can develop high-pressure points, and callosities and ulcers, which in these immunocompromised patients are portals for bacterial entry leading, as said earlier, to limb and life-threatening infections. Hence these foot abnormalities must be surgically corrected. In many cases, a suitable molded footwear and proper foot care can avoid serious complications and prevent surgery.
For more information consult a diabetic foot ulcer specialist online --> https://www.icliniq.com/ask-a-doctor-online/diabetologist/diabetic-foot%20-ulcer
Foot care is important to diabetic people because it is the region where most of the lesions or wounds begin in these patients. Also, the wound healing capacity of people with diabetes is very low. If they are prone to wounds or infections, they have more possibilities of suffering from severe complications.
Diabetic people should follow the below tips to care for their feet:
- Inspect the feet every day.
- Bathe your feet in lukewarm water.
- Be gentle while cleaning your feet.
- Moisturize your feet regularly.
- Cut your nails carefully.
- Never treat the corn in the feet yourself.
- Always wear clean and dry socks, especially in winter.
- Try wearing socks that are made for patients with diabetes.
Diabetics need to take special care of their feet. They need to visit the doctor to ensure that their feet are in a healthy state. A proper blood flow should be regulated to the legs. Avoid sitting with your legs down for a long period of time. Wash your feet regularly.
Diabetic feet are hard to cure completely. The best way is to prevent the first occurrence of diabetic foot. If the feet are prone to infections, then it becomes very hard to manage. In most cases, patients with diabetic feet undergo amputation surgery in the first five years.
Foot creams that are given for diabetes will depend on the health condition of the patient. The cream that is suitable for one patient might not be favorable for the other. So, it is better to get recommendations from diabetologists and dermatologists before using foot creams. You can get help from icliniq.com.
The condition of diabetes and toenails are related to each other. If a diabetic patient trims the nail too much, it might lead to ingrown nails. If the nails are not cut, then it might lead to the accumulation of dirt. Both these cases are harmful to diabetic people. It is necessary for them to keep the toenails clean.
It is bad for diabetic people to soak their feet because it will tend to increase the risk of infection if the skin tends to break down. The temperature of the water should be carefully noted if the patient is having damage to the nerves. If the water is too hot, then there are chances of burning your skin.
A prolonged condition of diabetes might cause diabetic neuropathy. It is a condition in which the patient suffers severe damage to the nerves. It might also cause pain and tingling sensation in the feet. It might also lead to sores or cuts in the feet. You can ask your doctor to provide tips for maintaining a healthy foot.
Diabetes people can use Vaseline or lotions on their feet. They should make sure that the Vaseline or lotions do not stay in between the toes. This might cause severe dryness and fungal infections.
The different signs of diabetic feet are:
- Changes in temperature of the skin.
- Changes in the color of skin.
- Pain in the legs.
- Swelling in the ankle or foot.
- Infection of toenails with fungus.
- Open sores that show slow healing.
- Dry cracks in the skin, especially around the heel.
In order to improve the circulation in the feet, the patient has to follow a few tips. They are:
- It is necessary to wiggle your toes every few minutes daily. Also, try to move your ankles up and down. This will help in increasing the blood flow in your feet and legs.
- Avoid wearing elastic stockings or tight socks.
- Stop smoking.
- Put your feet up when you are sitting.
- Be more physically active.
A diabetic patient has to avoid the following while taking foot care.
- Excessive cutting of the nails.
- Washing the legs with hot water.
- Self medications for corns in the feet.
- Keeping the foot moist all the time.
Last reviewed at:
23 Oct 2019 - 3 min read
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