[CNS] Experts who are convening for the mid-term continuing medical education (CME) on "High-risk diabetic foot" organized by the Association of Surgeons of India (ASI), UP Chapter and Indian Podiatry Association (IPA) in Kanpur on Sunday, 11 April 2010, are sounding an alarm bell for people with diabetes to be wary of diabetic foot. "People with diabetes can, over time, develop nerve damage throughout the body. Some people with nerve damage have no symptoms. Others may have symptoms such as pain, tingling, or numbness - loss of feeling - in the hands, arms, feet, and legs" informed Professor (Dr) Rama Kant, who is the President of ASI, UP, and Head of the Department of Surgery, at CSM Medical University (formerly King George's Medical College - KGMC) in Lucknow, India. Professor (Dr) Rama Kant will speak on "Surgical Approach to Diabetic Foot. How I do it" at this CME in Kanpur.
"It is not about money. No amount of money will give back my limb" said a 65 years old woman with diabetes (name withheld on request) who underwent limb amputation at the Gandhi Memorial & Associated Hospitals (GM & AH) in the past.
The diabetes-related complication which had devastated the life of the 65 years old woman is diabetic foot. "The foot of the patient with long-standing diabetes is often the site of neuropathic and vascular growth which poses a considerable threat, not only to the lower limb but also to the life of the patient" warns Prof Rama Kant.
Relatively diabetic foot is one of the leading causes resulting in long hospital stays for people with diabetes. It demands much care and attention by both the patient and healthcare personnel. Two major problems which predispose the patients with diabetes to amputation are the development of neuropathy due to uncontrolled diabetes over several years while result in damage to the nerves in the feet leading to the loss of sensation. They also develop certain high pressure points under the feet which result in the formation of callus which later turns in to an ulcer. In addition cigarette smoking will lead to nerve damage and reduced blood flow in the feet.
With increasing age, people with diabetes may develop diminished sensation and decreased peripheral circulation in the feet, and thus are at a heightened risk of developing foot infections.
Prof Rama Kant lists some ways people with diabetes can take care of their feet:
1. Keep feet clean – wash them regularly.
2. Use only lukewarm water – no hot water, heating pads, hot water bottles, iodine or alcohol.
3. Keep the feet dry – especially between toes-use unscented lotion or cream to keep skin soft.
4. Use only medicines recommended by your doctor
5. Cut toe nails straight across, not deep into the corners to help avoid ingrown toe nails.
6. Never use razors, knives or corn caps to remove corns.
7. Wear shoes or slippers at all times -never walk bare foot even at home.
8. Wear good fitting shoes/slippers - not tight or worn-out ones. Boots should be used only for short periods.
9. Check your feet daily and see your doctor immediately about foot problems.
Bobby Ramakant – CNS
(The author is a World Health Organization (WHO) Director-General's WNTD Awardee (2008) and writes extensively on health and development for Citizen News Service – CNS. Website: www.citizen-news.org, email: [email protected] )