Ref: CHB/News Bulletin/003/2012

Diabetic Foot Disease 

Diabetic foot is a term used to describe the various complications that occur in the feet of diabetics. This includes the formation of ulcers in the feet and infection of the feet. Diabetic feet complications if not picked up early can lead to devastating conditions which may lead either to amputation of the limb or even death.

Types of damage to diabetic feet:

diabetes_3aAs described earlier in this article, the high blood sugars of diabetics cause damage to their blood vessels. In the feet, which are the furthest part of the body from the heart, the poor blood supply to the tissues that results, predisposes diabetics to the formation of ulcers at pressure points. Similar ulcers can also occur in the feet of people who smoke and those with high cholesterol. These ulcers are termed vascular ulcers and occur due to poor oxygenation of the tissues. Obviously a diabetic whose sugars are uncontrolled, who smokes and has a high cholesterol is more at risk of vascular ulcer formation.

Additionally the poor circulation also causes damage to the nerves of the feet of diabetics. As a result, with time diabetics lose sensation in their feet as the nerve endings of the feet are furthest from the spinal cord. This loss of sensation is dangerous because it often goes unnoticed. This results in the unnoticed injuries to the feet and the formation of neuropathic ulcers.

diabetes_3bAs the immunity of a diabetic is low, diabetics often suffer from fungal infections between the toes and also over the rest of the foot. The combination of a decreased immunity, poor blood supply and damage to nerves often leads to the formation of severely infected deep wounds of the feet. These wounds are usually infected by not one but many germs causing difficult to treat infections. These infections progress rapidly and can often extend up to the one. They can also quickly destroy the skin and soft tissue of the feet and legs leading to a condition known as gangrene.

What can be done to prevent diabetic foot?

diabetes_3c

Although with time, certain complications of diabetes tend to set in, plenty can be done to delay their onset or slow their progression.

The foremost among these is regular follow up with your physician. Good follow up allows the physician to pick up changes at a very early stage when medical and nonmedical treatment can be optimized to provide the best possible outcome for you. By the time vascular and neurological complications are advanced it becomes harder and harder to treat diabetic foot.

If you already suffer from diabetic foot changes a number of things can be done to prevent it from advancing. Firstly since a high sugar is the root of the problem, good sugar control is essential.

Secondly if you smoke then you should quit and if your blood cholesterol is high consult your doctor about how to reduce it. If the blood supply to your feet is reduced then taking a regular walk will help improve the circulation to your feet. At the same time this will help you reduce your blood sugar levels.

Very importantly, if you suffer from diabetic foot then you should take out a few minutes each day to inspect your feet. Wash your feet, and then gently wipe them clean. Inspect all around your feet especially the bottom and between the toes. If you notice any problems with your skin or nails (such as calluses, ingrown toe nails or wounds) then visit your doctor or your podiatrist immediately. He or she will instruct you on what you need to do.

Remember that what may seem like a small injury to the foot, for a diabetic can take ones limb or life.

To be continued................

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