Why foot care is crucial for diabetics

Better foot care including specially designed aids can prevent foot amputations among diabetics. However, this dimension of diabetes is little talked about in India

August 13, 2014 03:33 pm | Updated 03:33 pm IST - New Delhi

An overall emphasis on maintaining foot health, remaining alert for anomalies and using orthotic devices like foot insoles can go a long way in reducing incidence of amputations and preventing disability among diabetics. Photo: K.R. Deepak

An overall emphasis on maintaining foot health, remaining alert for anomalies and using orthotic devices like foot insoles can go a long way in reducing incidence of amputations and preventing disability among diabetics. Photo: K.R. Deepak

With a surge in lifestyle diseases becoming the talking point of health forums and policy discussions in India, diabetes, along with cardiovascular diseases and hypertension, has become a central theme of discourse. The growing incidence of the insulin disorder, its implications and the resultant health burden are considered a major health challenge for the country in the coming years. However, when we talk of diabetes management, the only aspects that are focused are the need to maintain blood glucose levels, good levels of physical activity and weight control.

But little time is devoted to driving home the point that diabetes is a major cause of amputations and a lot of effort should be put in to ensure that ulcers and injuries do not become gangrenous.

An overall emphasis on maintaining foot health, remaining alert for anomalies and using orthotic devices like foot insoles can go a long way in reducing incidence of amputations and preventing disability among diabetics.

According to the World Health Organization, over 340 million people in the world suffer from diabetes. India, with almost 60 million diabetics, is home to the second largest population of diabetics in the world after China.

Estimates by the World Diabetes Foundation suggest that about 40,000 lower limb amputations take place in India each year, and a large number of them are due to diabetes-related complications.

Along with diabetes prevention, it is therefore important to focus on diabetes management mechanisms that include proper foot care. In cases when amputation cannot be avoided, efforts should be made to make the life of the patient easier with advanced prosthetics.

It is important to emphasise that proper diabetes management and careful foot care can help prevent foot ulcers. In developing countries, a major cause of foot ulcers is unsuitable shoes as well as the habit or the need to walk barefoot.

At Comprehensive Prosthetics and Orthotics (CPO), we have a foot care programme to help prevent foot sores by providing cushioning and support devices for the feet.

The condition

Insulin is a hormone produced in the pancreas that helps the body to convert glucose from food into energy. Diabetics basically lose control over this hormone and hence on the level of glucose in the blood. People with diabetes either fail to produce enough insulin (type 1 diabetes) or their bodies lose their capacity to use the insulin effectively enough so as to convert glucose to energy (type 2 diabetes). This is an irreversible condition but effective management can keep the ailment in control.

Diabetic foot is one of the complications caused by diabetes. 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.

Neuropathy or nerve damage leads to loss of sensation and skin injuries often go unrecognised because of this. Due to nerve damage, sometimes changes may also occur in the shape of the feet or toes. The skin of your foot may also be affected due to diabetes. It may become dry or crack and this may lead to infection. In extreme cases, these situations 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) or major (above- or below-the-knee amputation).

Foot management tips

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.

At Comprehensive Prosthetics and Orthotics (CPO), we have a foot care programme to help prevent foot sores by providing such devices.

(The author is Clinical Director and Global Chief Executive Officer of Comprehensive, Prosthetics & Orthotics.)

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