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  • 26Apr

    Amputation in diabetic foot – how to prevent it?

    Diabetes results in pathological changes in feet that lead to increased risk of ulceration, gangrene (death of tissue) and amputation. These pathological risk factors are peripheral neuropathy, peripheral arterial disease and foot deformities. Peripheral neuropathy is due to diminished function of nerves supplying skin, muscles and joints resulting in numbness, muscle imbalance and deformities of foot. Peripheral arterial disease is due to blockage of arteries in diabetes and is associated with occurrence of ulcers on foot and delayed healing. Foot deformities make them more prone to trauma and pressure ulceration.  

    An amputation results in diminished efficiency of a person. Amputation can be prevented with a better sugar control through regular treatment and better foot care through education of affected patients. The following guidelines given to the diabetic patients on foot care can help in achieving the above target.

    Daily feet inspection - patients are instructed to look after their feet with equal care as they take care of their face. The feet should be inspected daily for blisters, cuts, scratches and reddened areas. A mirror can be used to see the sole and the area between the toes. If the vision is poor, the help from other member of family should be taken for trimming of nails.

    Daily feet wash - the feet should be washed daily, especially between the toes. A moisturizer should be applied to prevent cracking of skin.

    Protection from heat - avoid taking bath with very hot water. Check temperature by pouring few drops over back of hand.

    Amputations can be prevented with better sugar control and foot care.

    Amputations can be prevented with better sugar control and foot care.

    Protection from cold - during cold weather socks can provide warmth. External heating equipment like hot water bottle, electric blanket or heating pad may cause damage or burns. They are to be avoided.

    Precautions during vacations - diabetic patients should not walk barefoot on hot surfaces like beaches or on the area around swimming pools. Protective slippers should be worn while walking and also while swimming in sea, river or pond because sharp objects may be present on the bottom. As far as possible, they should not walk barefoot.

    No bathroom surgery - do not remove a corn with a blade, any chemical agent or corn cap. Any foot problem should be dealt with by a trained person or a foot surgeon. Any adhesive tape should not be applied on foot unless prescribed by a physician.

    Footwear inspection - the shoes should be well fitting, preferably one size larger. They should be soft inside, the sole should provide adequate cushioning. The footwear should be inspected regularly for any foreign objects like nail points, torn linings, pieces of gravel and rough areas.

    Avoid prolonged soaking - prolonged soaking of feet in water while in bath tub may result in maceration of skin between the toes. It should be prevented.

    Socks or stockings should be properly fitting. The seams should not be very prominent as they may impinge and hurt. Tight elastic at the top should be avoided as it impairs the blood flow to the foot.

    Buying new shoes - shoes should be bought in the evening when the feet tend to be largest because of minimal gravity dependent swelling. The inner comfort should be the deciding factor. Always wear shoes with socks. Sandals with stopper between the toes should be avoided. In case of foot deformities, custom made shoes should be worn.

    Nails care – the toe nails should not be cut excessively at the end as it may result in ingrowing nails. This results in recurrent infection and pain.

    Quit smoking  – smoking aggravates the ischemia (lack of blood flow) in the extremities and delays healing. It is advised to undergo a regular foot review by a diabetologist every 3-6 months.

    Diabetes is a metabolic disorder resulting in deranged blood glucose homeostasis due to lack of insulin. Proper and regular treatment delays the target organ damage. The diabetes specialist should be consulted if there is any foot condition so as to avoid foot ulceration and risk of amputation. Patients should be aware that amputation in diabetic foot can be prevented by self foot control and care.

    Anna L.

    It’s all about health!
    I have academic background in drugs related Chemical Technology, as well as extensive professional experience in pharma and medical companies. My main area of interest is everyday life medicine. The goal of my articles is to give people informative answers to the questions that bother them, to dispel doubts and some common misbeliefs and also to inspire everyone to keep healthy lifestyle.

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