Diabetic Foot


Authors:
Dr. Urvashi Rathore
Dr. Preeti Kumari Yadav
Dr. Lubna Mirza.

There was a 50-year-old diabetic man who used to work as a farmer in a small town.
One day his wife pointed out that he had a blackish discoloration on his big toe, but he did not pay much attention to it. Over the next few days, it became darker and started to ulcerate. The ulcer grew rapidly in size, and this made the farmer anxious, so he decided to visit a nearby hospital. At the hospital, the doctor inquired about his diabetic control, and after doing a complete foot examination, the decision was made to amputate his big toe.
Throughout the world, it’s estimated that every 30 seconds one leg is amputated due to diabetes. If you have diabetes, here’s a way to keep standing on your own two feet: check them every day-even if they feel fine-and see your doctor if you have a cut or blister that won’t heal.

What is Diabetes?

Diabetes is a chronic, metabolic disease characterized by elevated levels of blood glucose (or blood sugar). Diabetes is caused by dysregulation of an important hormone called insulin. If there is a deficiency of insulin or there is resistance to insulin, people develop diabetes.

What are the complications of Diabetes?

High blood sugars lead to multiple complications which can be divided into two groups. Microvascular (small blood vessel) complications including eye, kidney and nerve damage and macrovascular (large blood vessel) complications including heart attacks and strokes.

Could You Have Nerve Damage?

Anyone with diabetes can develop nerve damage, but these factors increase your risk:

*   Blood sugar levels that are hard to manage
*   Having diabetes for a long time, especially if your blood sugar is often higher than your target levels
*   Being overweight
*   Being older than 40 years
*   Having high blood pressure
*   Having high cholesterol

What is Diabetic Foot?

A diabetic foot is one of the most significant and devastating small blood vessel complications of diabetes and is defined as a foot affected by ulceration that is associated with nerve damage and/or blockage of peripheral blood vessels in a patient with diabetes. Small foot ulcers can grow rapidly causing bone infection. To prevent systemic infection, foot amputation may be required which can be a source of disability in patients.

How can you prevent Diabetic Foot?

Tips for Healthy Feet include:

*   Check your feet every day for cuts, redness, swelling, sores, blisters, corns, calluses, or any other change to the skin or nails. Use a mirror if you can’t see the bottom of your feet or ask a family member to help.
*   Wash your feet every day in warm (not hot) water. Don’t soak your feet. Dry your feet completely and apply lotion to the top and bottom but not between your toes, which could lead to infection.
*   Never go barefoot. Always wear shoes and socks or slippers, even inside, to avoid injury. Check that there aren’t any pebbles or other objects inside your shoes and that the lining is smooth.
*   Wear shoes that fit well. For the best fit, try on new shoes at the end of the day when your feet tend to be largest. Break-in your new shoes slowly and wear them for an hour or two a day at first until they’re completely comfortable. Always wear socks with your shoes.
*   Trim your toenails straight across and gently smooth any sharp edges with a nail file. Have your foot doctor (podiatrist) trim your toenails if you can’t see or reach your feet.
*   Don’t remove corns or calluses yourself, and especially don’t use over-the-counter products to remove them they could burn your skin.
*   Get your feet checked at every health care visit. Also, visit your foot doctor every year (more often if you have nerve damage) for a complete exam, which will include checking for feeling and blood flow in your feet.
*   Keep the blood flowing. Put your feet up when you’re sitting and wiggle your toes for a few minutes several times throughout the day.
*   Choose feet-friendly activities like walking, riding a bike, or swimming. Check with your doctor about which activities are best for you and any you should avoid.

When to See Your Doctor?

If you experience any of these symptoms, don’t wait for your next appointment. See your regular doctor or foot doctor right away:

*   Pain in your legs or cramping in your buttocks, thighs, or calves during physical activity.
*   Tingling, burning, or pain in your feet.
*   Loss of sense of touch or ability to feel heat or cold very well.
*   A change in the shape of your feet over time.
*   Loss of hair on your toes, feet, and lower legs.
*   Dry, cracked skin on your feet.
*   A change in the color and temperature of your feet.
*   Thickened, yellow toenails.
*   Fungus infections such as athlete’s foot between your toes.
*   A blister, sore, ulcer, infected corn, or ingrown toenail.

What is the ‘Diabetic Care Schedule’?

Every Day:

*   Blood sugar check
*   Foot check
*   Diabetes medicine
*   Physical activity
*   Healthy eating

Every 3 months:

*   A1C Test
*   Doctor Visit

Every 6 months:

*   Dental Exam
*   A1C Test
*   Doctor Visit

Every Year:

*   Kidney Test
*   Cholesterol test
*   Dilated Eye Exam
*   Hearing check
*   Complete foot check

Just once:

*   Pneumonia shot
*   Hepatitis B shot

As Needed:

1.  Mental Health Check


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