Understand Diabetes and Foot Amputation

Diabetes has many complications like complications related to eyes, heart, kidneys etc. But the most common and threatening complication is a diabetic foot.


The maximum numbers of hospital admissions in diabetics are due to foot problems.

 
Causes of Diabetic Foot

High Sugar Levels

 When sugar levels are high, the person is more prone for infections as sugar is a good medium for growth of bacteria due to which infections occur rapidly. Hence it is of prime importance to keep your blood sugar levels under control and avoid diabetes related complications.

Vasculopathy

Diabetes affects blood vessels thereby decreasing the lumen. This in turn decreases blood supply and absence of proper blood supply delays wound healing, necrosis and gangrene of the foot finally leading to amputations if prompt medical intervention is not provided.

Neuropathy

Diabetic neuropathy is one of the most important and commonest causes of diabetic foot. 60 to 70% of diabetics suffer from neuropathy, many of which are asymptomatic. Diabetes affects nerves resulting in loss of sensations as a result of which patients do not feel the pain of minor wounds and tend to ignore minor infections, ulcers and pus formations which add to the problem which could finally lead to the limb being amputated.

Complications

The foot comprises of fat on the sole and a large number of tendons which traverse all the way to the leg upwards. As a patient keeps walking after developing an ulcer, it sooner or later gets infected, infection travels along these tendon sheath high up and away from the original foot infection. These infections if ignored or not treated promptly can become worse and can end up developing necrosis and gangrene of the affected toe or limb.

In people with diabetes a small foot problem can turn into serious complications. Some of the diabetes-related foot and leg problems include:

• Infections and ulcers (wounds) that take very long to heal or don’t heal. A small cut or injury can turn into a non-healing ulcer because of poor circulation and neuropathy.
• Corns and calluses- As due to neuropathy people with diabetes can’t feel if their shoes are causing pressure and leading to formation of corns or calluses. If these are not treated properly they can turn into ulcers.
• Dry and cracked skin as a result of poor circulation and neuropathy. The cracks can become sores with secondary infection.
• Nail disorders---like in-growing toenails and fungal infections of the nails. These occur due to poor circulation and neuropathy.
• Charcot foot (a type of complex foot deformity) develops due to loss of sensation and an undetected broken bone. This can lead to damage of the soft tissue of the foot.

Precautions to Avoid Diabetic Foot

Following are the few simple tips for foot care:

• Wash your feet daily with warm water. Take care that water should not be very hot as it can result in burns.
• Dry feet properly with cotton cloth or towel especially the web spaces to avoid fungal infections.
• Cut/trim your nails regularly.
• Never walk bare feet.
• Wear comfortable foot wear (with broad front end).
• Shop for your shoes in the evening, when size of the foot increases slightly.
• Wear cotton socks which should be changed daily.
• Inspect your feet daily for injury, cuts, scrapes, redness, skin or nail problems, swelling and discoloration.
• Actively look for signs of fracture like swelling, change in size, shape, or direction of the foot.
• Don’t ignore any problem in your feet even a minor pain.
• Cut foot nails regularly. Go for pedicure regularly.

Foot and lower limb problems in people with diabetes needs prompt and optimal treatment. If treatment of any problem of foot is delayed (even a minor cut or injury) it can become a serious complication which can cause loss of your foot, your leg, or your life.

If you note any problem in your feet, seek immediate help.

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