BENGALURU: If you have diabetes and your blood sugar levels are too high, it can damage your nerves or blood vessels. You may not feel a cut, a blister or a sore. Blood vessels damage means that the feet does not get enough blood and oxygen. Injuries to the foot can cause ulcers and infections and in severe cases it may even lead to amputation. It is harder for your foot to heal, if you do get a sore or infection.
Occurance
In individuals suffering from diabetes, neuropathy which is peripheral nerve dysfunction can be combined with peripheral artery disease (PAD), leading to poor blood circulation in the extremities (diabetic angioplasty). Owing to which the individuals suffering from diabetes are unable to feel pain. This translates into injuries being undetected for prolonged periods, resulting in minor injuries and alterations becoming gateways to potentially disabling infections, which may necessitate lower limb amputation. One of the main causes of non-traumatic amputation in diabetics is due to foot infections.
Importance
Foot care in diabetics is of paramount importance as it goes un-noticed leading to infections, and untreated infections can lead to gangrene, which in turn may require amputation.
Diabetes induced neuropathy causes the skin to dry up, and dry feet crack making it easy for the germs to enter the body. Nerve damage can also lead to changes in the shape of the patients feet ( Charcot foot), which makes previously comfortable shoes hard to walk in. This causes friction leading to calluses and bunions exposing skin to germs.
Caring for your feet
Foot care should be the prime consideration in diabetics, and is not difficult. Diabetics should regularly check their feet for any signs of damage. Look out for the below warning signals of foot damage:
■ Bruises
■ Cuts
■ Sores
■ Swelling
■ Grazes
■ Colour changes
■ Ulceration
■ Hard skin
The author is a consultant vascular and endovascular surgeon at Columbia Asia Referral Hospital, Yeshwanthpur
It is important to recognise early warning signals of foot problems
■ Burning, tingling, or painful feet
■ Loss of sensation in the feet
■ Changes in shape or colour of your feet
■ Thickening or discoloration of toe nails
■ Onset of blisters, ulcers, sores, or red spots.
Always avoid taking the following risks
■ Diabetics should not use over the counter medications for treating warts or corns on the feet.
■ Never walk around the garden or outside barefoot, wear perfect fitting shoes for indoors and outdoors.
■ Regularly use heating pads or keep the feet in a bucket of warm water.
■ Avoid smoking as it reduces the circulation of blood and healing process of wounds drastically increases.
■ Never cross the legs while sitting for long period of time.
If any of the above are noticed a doctor should be consulted immediately, as it may lead to serious health complications. Treatment of diabetic foot complications can be prolonged and challenging, hence prevention is better than cure.
Footcare routine
■ Check your feet every day
■ Wash your feet every day
■ Keep the skin soft and smooth
■ Smooth corns and calluses gently
■ If possible, trim your toenails regularly. If you cannot, ask a foot doctor (podiatrist) to trim them for you.
■ Wear shoes and socks at all times
■ Protect your feet from
hot and cold
■ Keep the blood flowing
to your feet
What else can be done
■ Periodic medical check-ups including foot check-ups and monitoring your ABCs (A1c, blood pressure, and cholesterol)
■ Monitoring sugar levels daily
■ Exercising every day, and
■ Eating a balanced diet