Possibly the most dreaded complication arising out of diabetes is a foot wound that leads to leg amputation.
Even though many diabetics breathe a sigh of relief, thinking that is the end, that their foot wound is healed, often it is just the beginning of foot problems. At first, it may be a toe or toes, but if great care is not taken, further amputations can follow.
Why the foot breaks down and becomes a life/limb threat is unclear to most of the diabetic patients. Uncontrolled or prolonged duration of diabetes causes neuropathy (damage to the nerves) in the feet, poor blood circulation to the feet, weakens the bone strength, decreases cushion effect of the sole, makes the skin fragile as well as dry, foot deformities (clawing of toes) leading abnormal and unsteady gait. If a diabetic does not closely monitor his foot health, he may suffer an injury. The body’s ability to heal (immune function) also is hindered by diabetes. An untreated wound can become infected with the tissue even dying without the patient feeling pain. Gangrene can set in, foot bones may be infected which would lead to amputation- a life-saving surgery by a team of specialists to ensure a healthy outcome.
If you are a diabetic, there certainly are lifestyle changes you can make to better your chances of avoiding a foot ulcer along with the other consequences of the disease. If you smoke or drink alcohol, understand that it may affect your blood tubes and nerves respectively, therefore quit that habit. If you have a foot ulcer, never walk with that foot until wound heals. Constant monitoring and control of your blood sugar is vital for the wound healing. You can change your diet and lose weight. All these changes significantly facilitate wound healing.
If your wound is over 2 weeks duration and slow in healing, better consult a Podiatrist immediately. You may have to undergo certain special tests (peripheral angiograms, nuclear scans, x-rays, duplex scans, tissue/pus culture and sensitivity, nutrition deficiencies etc.) for identifying the root causes of delayed healing and take remedial actions promptly.
I have no intention to frighten diabetics, rather to emphasize the importance of managing their foot problems and being proactive in the wound care for avoiding major amputations.
Dr. GopiChellan,
MBBS, Ph.D. (Podiatry), PDF (Podiatric Surgery)
Podiatry Consultant
Aster Prime Hospital
Ameerpet, Hyderabad.
