To bring down the number of people with diabetes who lose limbs to amputations because of decreased blood circulation to feet and neuropathy, a conference titled ‘Diabetic foot limb salvage’ was conducted by KIMS Hospitals in Secunderabad on Sunday.
Focus was to educate general physicians working in towns and rural localities about advanced wound care options available, better management of diabetic foot ulcers even in remote areas.
Dr Bhaskar Rao, MD of KIMS hospitals inaugurated the conference.
Specialist doctors from the hospital claimed that 70% to 80% of rural diabetic patients lose their limbs to amputations, and doctors can salvage the limbs in only 20% to 30% of the cases. However, in major cities such as Hyderabad, limbs are salvaged in 80% of the patients. Lack of awareness about Diabetic Neuropathy, blockage in blood vessels in feet was pointed as reason for the issue in the rural areas.
The doctors said that diabetes causes a dangerous combination of nerve damage and impaired blood circulation that contribute to ineffective wound healing in lower extremities. Foot care is most important in diabetes. Even a small injury leads to closure of vessels, and infection or gangrene. Eventually, the limbs have to be amputated.
A consultant Vascular and Endovascular surgeon, Dr Ranjith Kumar A said that many people who have diabetes tend to be negligent when their feet are injured. As a result, the lesion do not heal and the blood vessels are gradually clogged. They either neglect initially as they do not have pain or sensation. Only when someone points out, they go to local RMPs.
“They consult specialist doctors only when there is no relief and toes are damaged. The infection or gangrene starts without the knowledge of the patient. This means that a large part of the feet will have to be removed. On the other hand, if the patient consults a vascular surgeon, the patient can undergo vascular surgery based on the need,” said Dr Ranjith Kumar.
A Vascular surgeon, Dr Rahul Laxminarayana said that foot ulcers account for 85% of the causes of amputation of the leg in people with diabetes.
Preventive steps
Dr Narendranadh Meda, head of the Vascular and Endovascular Surgery Department at the hospital, said that if someone with diabetes has an ulcer on feet, redness in feet with fever, swelling in the feet, sudden onset of pain in the feet, they have to consult a primary care physician or a vascular surgeon before it is late. They will assess the feet and take up further management.
“Those who have diabetes have to undergo diabetic foot assessment once a year which includes sensation test, vibration test, and blood circulation test. Shape of foot has to be assessed. Pressure scan helps to know if there is damage to nerves, if blood vessels are blocked. These tests are performed at tertiary care hospitals which have vascular surgeons. General physicians can do basic assessment,” said Dr Narendranadh.
