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Diabetic Foot

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Diabetic foot refers to a series of foot-related complications that arise due to uncontrolled diabetes. It is characterized by nerve damage (neuropathy) and poor blood flow (peripheral arterial disease) in the lower limbs, making the feet vulnerable to injuries and infections. If left untreated, diabetic foot can lead to severe complications, including foot ulcers, infections, and, in extreme cases, even amputation.

I. Cause and risk factors associated with the Diabetic foot

Diabetic foot is primarily caused by long-term, uncontrolled diabetes, particularly when blood sugar levels remain elevated for extended periods. High blood sugar levels can damage the blood vessels and nerves, impairing the body’s ability to heal and fight infections. This combination of factors makes the feet susceptible to injuries and challenges in healing, leading to the development of diabetic foot complications.

Several factors contribute to the increased risk of developing diabetic foot among individuals with diabetes. This features Poor Blood Sugar Control, Foot Deformities, Poor Foot Care, chronic smoking and uncontrolled hypertension. 

II. Signs and Symptoms of Diabetic Foot

Diabetic foot often presents with several noticeable signs and symptoms that warrant attention. These may include numbness or tingling in the feet, loss of sensation, foot ulcers, and swollen feet. Recognizing these warning signs early on is crucial for timely intervention and effective management.

  • Numbness or Tingling in the Feet: Diabetic neuropathy can cause a sensation of numbness or tingling in the feet.
  • Loss of Sensation in the Feet: As diabetic neuropathy progresses, it may lead to complete loss of sensation in the feet.
  • Foot Ulcers: Diabetic foot ulcers are open sores or wounds that do not heal properly. They often develop due to pressure points, trauma, or repetitive stress on the feet.
  • Swollen Feet: Poor blood flow in the feet, a condition known as peripheral arterial disease (PAD), can cause swelling or oedema in the lower extremities.

III. Diagnosis of Diabetic Foot

The diagnosis of diabetic foot involves a comprehensive assessment by healthcare professionals. This includes taking a detailed medical history and conducting a thorough physical examination of the feet. Additionally, specialized tests are employed to evaluate nerve and blood vessel function in the feet, aiding in accurate diagnosis and personalized treatment planning.

  • Medical History and Physical Examination: The first step in diagnosing diabetic foot involves taking a detailed medical history, including the duration and control of diabetes, any previous foot issues, and lifestyle habits
  • Tests to Evaluate Nerve and Blood Vessel Function: Specialized tests are employed to assess nerve function (nerve conduction studies) and blood flow to the lower limbs (ankle-brachial index and color doppler). 

By combining medical history, physical examination, and specialized tests, healthcare professionals can accurately diagnose diabetic foot and create individualized treatment plans. Early diagnosis allows for timely intervention, promoting better foot health and reducing the risk of severe complications associated with diabetic foot. Regular foot check-ups and diligent foot care play a vital role in maintaining the well-being of individuals with diabetes.

IV. Treatment of Diabetic Foot

Effective management of diabetic foot treatment requires a multi-faceted approach. Options for diabetic foot ulcer treatment may encompass ulcer debridement and regular dressing, optimization of blood sugar level, medicine to promote better blood flow, and footwear for pressure point offloading.

  • Ulcer debridement and regular dressing: Debridement of a wound entails the removal of all non-healing tissue, including necrotic and devitalized tissue and the callus that has formed around the wound. Reduced plantar pressures and the creation of granulation tissue and re-epithelialization are two benefits of this procedure.
  • Optimization of blood sugar level:Higher blood glucose level is related with a lower inflammatory response and a weaker host defence against infection. Primary aim of keeping blood sugar level at desired range during treatment of Diabetic foot is to allow tissues to heal naturally.
  • Medicine to promote better blood flow: Poor blood circulation makes the healing more difficult and prevents ulcers from healing naturally. To support the healing, medical professionals prescribe a few medicines to promote blood flow. 
  • Footwear for pressure point offloading: Under this kind of treatment patients are suggested to wear offloading footwear. These shoes are designed to redistribute pressure in these areas. People at risk for foot complications such neuropathic ulcers, Charcot foot, and infection may benefit from therapeutic shoes.

V. Prevention of Diabetic Foot

Preventing diabetic foot is of paramount importance to avoid potential complications. The following prevention measures are instrumental in minimizing the risk of developing diabetic foot:

  • Proper Foot Care: Regularly inspecting and caring for the feet can prevent minor problems from escalating.
  • Regular Foot Examinations: Frequent foot check-ups by healthcare professionals can detect any issues early on.
  • Monitoring and Controlling Blood Sugar Levels: Maintaining optimal blood sugar levels is crucial in preventing diabetic foot.
  • Early Intervention: Addressing minor foot problems promptly can prevent their progression into more severe complications. Seek medical attention immediately for any foot issues.
  • Healthy Lifestyle Habits: Adopting a balanced diet, regular exercise, and avoiding smoking can contribute to overall diabetes management.

VI. Complications of Diabetic Foot

Neglecting the management of diabetic foot can lead to severe complications, including infection, osteomyelitis (bone infection), and, in extreme cases, amputation. Understanding these potential complications emphasizes the urgency of prevention and timely treatment.

  • Infection: Diabetic foot ulcers, open wounds that do not heal properly, are susceptible to infections. High blood sugar levels impair the body’s ability to fight off infections, making the feet vulnerable to bacterial 
  • Osteomyelitis: Diabetic foot infections can extend to the bones, causing osteomyelitis, a serious condition where the bones become infected and inflamed.
  • Gangrene: Reduced blood flow to the feet due to peripheral arterial disease (PAD) can lead to tissue death (gangrene).

VII. Conclusion

Diabetic foot is a serious and potentially devastating complication of diabetes that demands proactive care and timely interventions. Early detection, proper management, and preventative measures are crucial in ensuring the well-being of individuals with diabetes. By focusing on foot care, regular check-ups, and maintaining healthy blood sugar levels, the risk of diabetic foot and its complications can be significantly reduced. Understanding the importance of preventing and treating diabetic foot is vital in safeguarding the quality of life and overall health of those affected by diabetes. Remember, awareness and proactive approach can lead to a healthier and happier tomorrow.

This disease can cause hurdles in the lifestyle of an individual but diagnosis on the right time is the cure. Dr Rajendra Bansal is a renowned vascular and pain specialist who understands that identifying and providing remedies to issues before they worsen greatly improves patient outcomes. As a specialist in minimally invasive procedures, he is able to treat several types of diabetic foot using noninvasive methods.  If you live in or around Jaipur and are experiencing leg pain, please visit Dr Rajendra Bansal and his staff at either Narayana Multispeciality Hospital or Flowcare Intervention & Pain Clinic.