HYDERABAD: As November 14th marks World Diabetes Day, let’s delve into the impact of diabetes on feet through insights provided by Dr Radhika Malireddy, a Plastic and Diabetic Foot Surgeon from the Department of Vascular and Endovascular Surgery at CARE Hospitals.
Diabetes doesn’t confine its impact merely to numbers; its consequences extend beyond, affecting various body parts from eyes to feet. These consequences include retinopathy, nephropathy, diabetic neuropathy, premature atherosclerosis, increasing the risks of stroke, myocardial infarction, and peripheral vascular disease in individuals.
Amidst the myriad issues triggered by diabetes, its effects on the feet are particularly concerning. Approximately 15—25% of diabetes patients will develop diabetic foot ulcers during their lifetime. Shockingly, every 20 seconds, a limb is lost somewhere in the world due to diabetes.
Among the multiple reasons how diabetes affects the feet, diabetic neuropathy takes centre stage, impacting sensory, motor, and autonomic nerves supplying the feet. This often results in decreased or complete loss of sensation and foot deformities. Consequently, there’s increased pressure on specific areas of the foot, thickened skin, and, if unaddressed, the formation of ulcers occurs. A staggering 60% of ulcers can be attributed to neuropathy, emphasising the preventable nature of these complications.
Peripheral vascular disease, another consequence of diabetes, significantly heightens the risk of reduced blood flow to the feet. This disease stiffens blood vessels and causes artery blockages, further complicating the foot health of individuals with diabetes. Additionally, diabetics are more susceptible to infection due to decreased immunity, impaired vision, increased risk of foot injury, while smoking further increases the risk of peripheral arterial disease.
Identifying foot ulcers’ symptoms is crucial: swelling, redness, warmth, foul smells, or injuries to the feet. If a diabetic patient notices any of these symptoms, immediate consultation with a healthcare professional is imperative. Diagnosis plays a pivotal role. Diabetic foot patients should undergo assessments for wounds due to neuropathy, ischemia, decreased blood supply, or infection. Treatments range from debridement and antibiotics to procedures like MR Angiogram, balloon angioplasty, stenting, surgical offloading, and microvascular reconstruction. Surgical offloading can also address wounds due to toe deformities or altered biomechanics.
Recognising the complexity of diabetic foot issues, a Multidisciplinary Team (MDT) approach has emerged as a crucial strategy. This approach involves collaboration among diabetic foot surgeons, vascular surgeons, interventional radiologists, and wound care nurses. Internationally recognized for its efficacy, MDT tackles neuropathy assessment, enhances blood supply, and employs advanced surgical techniques for foot and limb salvage.
Amidst the myriad issues triggered by diabetes, its effects on the feet are particularly concerning. Approximately 15—25% of diabetes patients will develop diabetic foot ulcers during their lifetime
Steps to keep your feet safe