Health: DIABETIC FOOT

Diabetes is a chronic non communicable disease in which the blood glucose levels remain higher than normal levels. Uncontrolled high blood glucose levels cause damage to various parts of the body including eyes, kidneys, nerves, e.t.c. Off all complications of diabetes in the body, diabetic foot happens to be the most troublesome complication. Diabetic foot refers to the changes which occur in the feet of a diabetic patient, resulting in amputation. In this condition, there can be ulcers and wounds in one or both feet. These tend to be resistant to treatment and progress rapidly. Due to these ulcers, the overlying skin can slough off. Sometimes part of or total toes can also become soft and slough off spontaneously. Thus the foot becomes disfigured and one finds it difficult to walk. This condition occurs in diabetics due to multiple causes. Diabetes leads to constriction of blood vessels and the small blood vessels are affected early in the disease. These vessels carry not only blood but necessary nutrients to various parts of the body, Thus the blood supply and necessary oxygen and nutrient substances for tissues are cut off. The nerves are also damaged due to diabetes. This leads to reduced sensation in the feet, making one more prone to trauma. One cannot feel the ground below very well hence unknowingly; he or she may step on rough grounds, not feel it and easily hurt oneself. A diabetic is more prone to infections because increased levels of glucose in the blood make a fertile ground for germs to breed and multiply. If the blood glucose level remains high, these infections flare up, spread easily and are resistant to treatment. Smoking and use of alcohol aggravates the damage to blood vessels and nerves caused due to diabetes. Apart from this if somebody is taking some neurotoxic medicine like isoniazid (anti T.B. drug) or stavudine(anti HIV drug), the damage is accentuated. Initially one has abnormal sensations in the affected foot or feet like burning, tingling, crawling of insects, e.t.c. Later on the sensations are diminished. The sufferer tells very clearly that instead of normal ground below, he feels as if he is walking on cotton or wool. At this stage, the damage can be retarded or stopped with good control of diabetes and certain precautions. Physical changes and deformities appear later as the nervous and vascular damage continues. Gangrene of the toes or entire foot starts. But this becomes a stage of no return. Amputation of the affected foot partly or in total remains the only treatment available. Good control of diabetes is the best precaution one can take against development of diabetic foot. More higher the levels of blood glucose, more chances are of commencement of this complication. Over a long time, it can develop with good control of diabetes also, but in that case the severity of damage will be less. This includes adherence to the diabetic diet and prescribed medicines. A diabetic patient has to take very good care of his feet. It is said that he needs to keep his feet more clean and dry than the face. One needs to be very careful while cutting toe nails that there should be not cut on the skin. For cutting corns and callosities, one should go to a professional expert where it can be done with good hygienic precautions. Otherwise small injuries tend to get aggravated and form big wounds. Shoes worn should be very comfortable and fitting well. In no way the toes should be constricted due to tight shoes. One should avoid walking bare foot, i.e. without shoes as this makes one more prone to trauma. A diabetic patient should be informed about, “diabetic foot”. He needs to be very serious about it and take notice at the development of earliest symptom. E-mail-rachna212002@yahoo.co.uk