As per National Center for Biotechnology Information, around 25 per cent of people with diabetes develop diabetic foot ulcer. Additionally, according to recently-released statistic by the World Health Organization (WHO), one in every five people with diabetes who have developed a severe infection after diabetic foot have to undergo amputation that may affect the family’s livelihood.
Diabetes has emerged as a global pandemic that has silently infiltrated many households in India. According to WHO, India will see around 10 crore cases of diabetes in the next 10 years. This increase in the number of diabetes cases in India is griming, and diabetic foot ulcer is a common complication developed by diabetics in India, said Dr Amar Pal Singh Suri, MBBS, CPP (Podiatry), Diabetic Foot Care Center, New Delhi.
A diabetic foot may result in:
*Peripheral neuropathy or damage of the nerves present in the lower extremities
*Peripheral ischemia or restricted blood flow in the lower extremities
*Infection caused by bacteria because bacterial growth is favoured by impaired tissue energy metabolism and the glucose-rich tissue environment.
“Identifying the crucial risk factors and making a treatment-oriented assessment for diabetic foot requires a persistent and unhindered diagnostic approach. Thus, people with uncontrolled blood glucose levels must get a comprehensive foot inspection done once every year,” said Dr Suri.
Symptoms which are typical include:
*Blisters or other wounds on the foot
*Numbness, tingling, and pain in the legs
*Loss of balance
*Discoloration of skin
*Foul smell from foot
How to prevent diabetic foot ulcers
Prevention is always considered a key to good health, but not all diabetic foot disorders can be prevented, said Dr Suri. “However, one can reduce their risk of developing diabetes ulcers by following appropriate evidence-based prevention and management protocol. People with diabetes must ascertain to control their blood sugar levels, wear well-fitted shoes, avoid treating their corn at home, avoid smoking, and avoid consuming excessive amounts of alcohol,” said Dr Suri.
How to manage diabetic foot?
According to Dr Suri, the primary goal is to obtain wound closure as expeditiously as possible. If a diabetic foot is left untreated, it can develop complications like wet gangrene, cellulitis, abscess, and necrotising fasciitis. “The intricacies of diabetic foot usually cause partial or complete foot amputation. Also, the resolution of foot ulcers decreases the recurrence rate, thereby lowering the probability of lower extremity amputation in people with diabetic foot ulcers. In cases where there are no infections at the site of ulcers, health care professionals usually remove dead cells and apply some topical medicines or dressing to the ulcer.
“However, managing diabetic feet, where the infection has set in, has usually been distressing. Data suggests that one in every five people with diabetic feet who have been hospitalised due to severe foot infection underwent foot amputation, and about 50 per cent of them later died within five years after the amputation,” observed Dr Suri.
Meanwhile, the science of diabetic foot wound healing has progressed significantly over the past few years. “Doctors are now using New Chemical Entities (NCEs) like DPOCL (Diperoxochloric acid) for managing infected diabetic foot ulcers. The antibacterial and wound healing properties of NCEs have attracted many healthcare professionals to use them,” said Dr Suri.
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