Diabetic foot disease is a complex interplay of several factors acting simultaneously, being a common, but preventable cause of foot amputation worldwide. Long-standing, poorly controlled diabetes can damage the inner lining of the tiny blood vessels due to which the small nerve ending lose their capacity to provide sensation(neuropathy), the small muscles of the foot get atrophied (shrunken) and the oxygen supply is reduced. The defence mechanism of the body, to remove dead cells and activate the healing process is also compromised in long-standing diabetes (immune dysfunction). As a result of all these factors, the normal curvature of the foot is distorted (leading to Claw foot, Hammer toe, Charchot’sfoot)and normal pain sensations are lost, so minor trauma often goes unnoticed.
People with Diabetes should care for their feet as meticulously as their faces. They should do a daily feet inspection, using a mirror to see the underside of the feet. Keep their feet clean and adequately moisturized (do not over moisturize). Clean carefully between the toes and dry it properly. Always wear comfortable, well-fitting shoes, preferably covered. Do not use very hot water to soak your feet. They should avoid walking barefoot and inspect the inside of their shoes before wearing them. Do not wear too tight stockings or use elastic bands to keep your socks up. Lastly, they should be very careful while cutting the toenails, never cut too deep or into the sides.
People who are at greater risk of developing diabetic foot disease are those with poor glycaemic control, smokers, pre-existing foot deformity, peripheral arterial disease and loss of sensations in the feet. Those with Diabetic retinopathy or Diabetic kidney disease are known to have pre-existing vasculopathy and are at higher risk of developing diabetic foot disease.
Diabetes patients commonly feel pins and needles like sensation in the feet, bilaterally OR burning sensation in the soles especially aggravated at night. They should also watch for changes in the colour and temperature of their feet and/or blister, sore, ulcer or ingrowing toe nail.Painful cramping in the thighs, buttocks or calves during walking, which gets relieved on resting (intermittent claudication) is an important early sign of compromised blood flow to the lower limbs and should not be ignored. If you have any such symptoms you must contact your doctor immediately. For further information watch my youtube video with my co-workers https://youtu.be/pltGsJWg_D0 – diabetic foot disease by Dr Nandini Chhabra