According to World Health Organisation, over 340 million people in the world suffer from diabetes and India is home to almost 60 million diabetics.
The World Diabetes Foundation estimates that 40 to 70 per cent of all lower limb amputations in the world are related to diabetes and that 85 per cent of all diabetes-related amputations begin with a foot ulcer.
Diabetes complications include nerve damage and poor blood circulation, referred to as neuropathy. This makes the feet vulnerable to ulcers. Many people with diabetes lose sensation in their feet and often fail to recognise skin injuries that may develop into infected ulcers. In some people, these lead to gangrene and require amputation to save life.
Estimates by the Word Diabetes Foundation also suggest that about 40,000 lower limb amputations take place in India each year, and a large number is due to diabetes-related complications. Therefore, along with diabetes prevention, it is important to focus on management mechanisms including foot care.
Diabetic foot is a term used to denote feet-related complications that can arise in a person suffering from diabetes, including infection, ulcers, sores and neuropathy. In developing countries, a major cause of ulcers is unsuitable shoes and walking barefoot. Neuropathy or nerve damage leads to loss of sensation leading to neglect of injuries. Due to nerve damage, changes may also occur in the shape of the feet or toes.
The skin of the foot may also become dry or develop cracks, leading to infection. In extreme cases, this may necessitate amputation to prevent a gangrenous wound from poisoning the entire body. Sometimes, a non-healing ulcer that causes severe damage to tissues and bone may require surgical removal. Amputation may be minor (removal of toes of feet) or major (involving the leg above or below the knee). Amputations are reported to be 15 times more common in diabetics, than in others. Neuropathy makes your foot insensate to pressure. Studies and research have suggested that long-term use of foot orthoses like insoles can reduce the incidence of diabetes-related amputation. Such devices help reduce pressure on the foot and reduce the risk of sores or ulcers that may be the potential cause of amputation.
Foot management
Take sores and injuries seriously: There is no way an injury or a skin sore can be ignored. If a foot sore hasn’t healed within a normal duration, immediately contact your doctor..
Use foot insoles and orthoses: Shoe insoles are foot support devices designed to be worn inside the shoe to lend support to your foot and prevent excessive pressure on one area. They are often made of soft foam like substance and can slip into your shoes to provide cushioning to your feet. These are especially designed to comfortably accommodate a foot, reduce pressure on the sole and toes and keep the feet injury free. They also relieve areas of the feet that usually take excessive pressure. Even if you have been standing or walking for a long time, insoles will provide relief to your feet. For people with diabetes, this is very crucial to prevent injury or sores.
The writer is the Clinical Director and Global CEO of CPO (Comprehensive Prosthetics and Orthotics).
