Even as efforts are on to educate people on the damage uncontrolled diabetes causes to the eyes, heart, kidneys, and the brain, doctors warn diabetics against being dismissive about the impact on the feet.
It begins with lack of sensation in the feet, which is called diabetic neuropathy. The diabetic then does not experience even a wee bit of irritation, leave alone pain, from the ulcers or wounds on the sole or in the web between the toes. Uncared, these can lead to gangrene and require amputation.
At least 15 per cent of the Type 2 diabetics end up with a diabetic foot. And, 45 per cent of the total cases of amputation of legs constitute the diabetic foot, says diabetologist S.K. Suresh Kumar.
“It is not enough if they fear damage to the internal organs alone. Diabetics should also watch their step. They cannot afford to injure their feet. Therefore, wearing appropriate footwear even at home, proper cleaning, and even safe pedicure are vital to preserving the feet,” the diabetologist explains.
“For instance, diabetics with neuropathy should not wear slippers with ‘V’ strap. The first three toes almost dig into the slipper for good grip. Over some time, this can lead to sores that can cost you your toes,” says the doctor.
Type 2 diabetics are bound to develop some form of neuropathy in five to ten years since being diagnosed with diabetes. “It affects the longest nerves in the body when diabetes is uncontrolled. That’s why the feet are affected.”
Vascular problem can worsen the situation. Poor blood supply to the calf muscle can cause pain at this spot and render walking difficult. The diabetic will have to limp because of the pain (intermittent claudication). Initially, there will be pain after walking even a very short distance. This will worsen to pain even when the person is resting.
Uncontrolled diabetes causes endothelial dysfunction. In the inner lining of the blood vessel, the endothelial cells are tightly packed. Uncontrolled diabetes compromises the integrity of this packing and leads to unhealthy fat entering the gaps and forming plaque deposits. This severely restricts blood supply.
Smoking also causes plaque deposit. A combination of uncontrolled diabetes and smoking is like matchstick and gunpowder relationship; it can explode into a severe vascular problem.
Choked blood supply carries other risk too. Sores or wounds in the feet can heal only if blood carries nutrients and antibiotics to the site of the ulcer or wound.
