The number of new patients with diabetic foot conditions visiting the State-run Karnataka Institute of Endocrinology and Research (KIER) is on the rise after the second wave. From 3,817 new patients in 2020, the number shot up to 5,281 in 2021. The hospital, which is running a diabetic foot registry since 2016, has seen nearly a 1,000 patients in the last three months alone.
Foot problems are common in people with diabetes. They can happen over time when high blood sugar damages the nerves and blood vessels in the feet. The nerve damage, called diabetic neuropathy, can cause numbness, tingling, pain, or a loss of feeling in the feet. The nerve damage can also lower the patient’s ability to feel pain, heat, or cold. Nerve damage, along with poor blood flow — another diabetes complication — puts the patient at risk for developing a foot ulcer (a sore or wound) that could get infected and not heal well. If the infection does not get better with treatment, the toe, foot, or part of the leg may need to be amputated (removed by surgery) to prevent the infection from spreading.
Of the total 50,000 pairs of diabetic feet screened since 2016 at the hospital, 1,015 patients who were referred for amputations came back to the hospital for follow-up. These include 898 major (below knee or above knee) amputations and 117 minor (one to three toes) amputations.
Orthopaedic surgeon Pavan Belehalli, who heads the department of Podiatry at the institute, told The Hindu that these amputations were either done at the institute or were followed up here. “Many patients would have gotten the surgeries done outside after the diagnosis and evaluation which are out of our records,” he said.
Pointing out that many patients missed follow-up during the first and second waves of the pandemic, the doctor said that they came back with aggravated foot conditions after the second wave subsided. Moreover, the number of new onset of diabetes cases too increased post COVID, he said.
“As the number of diabetic foot conditions is on the rise, there is a need to identify these conditions at the primary health centre (PHC) level and refer them to us for early intervention,” he said.
Project Safe Feet-Safe Ride
To create awareness about the disease, a campaign titled “Project Safe Feet-Safe Ride” was launched by the institute in association with FootSecure, Indian Podiatry Association and Arogyaseva, a NGO, on Saturday.
Sanjay Sharma, founder of FootSecure and Secretary of the Indian Podiatry Association’s Karnataka unit, said the campaign is aimed at creating awareness of diabetic foot disease among the general public as well as educating clinicians on early diagnosis and effective treatment.
“Diabetic foot is currently being inappropriately managed, leading to amputations, which can be prevented through podiatric interventions. Podiatry, a speciality in medicine that deals exclusively with the diagnosis and treatment of disorders of the foot and ankle, is not a part of the curriculum in Indian medical colleges,” De Sharma said.
In the next phase of campaign, which is going to commence on September 9, a team of doctors will ride across 31 districts of Karnataka to create awareness and screening.
Virtually inaugurating the campaign, State Health Commissioner Randeep D said Karnataka is at the forefront of diabetic management by maintaining a diabetes registry. “We are also the first State in the country to have an exclusive government diabetes hospital with a podiatry department,” he added.
