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Cardio Diabetes Medicine 2017 479

Foot Care in Type 2 Diabetes

Dr.Vijay Viswanathan MD., Ph.D., FICP, FRCP (London & Glasgow)*
& Anitha Rani.A**

*Head & Chief Diabetologist, M.V.Hospital for Diabetes & Prof. M. Viswanathan Diabetes Research Centre
(WHO Collaborating Centre for Research, Education and Training in Diabetes), Royapuram, Chennai.
** Prof. M. Viswanathan Diabetes Research Centre

Abstract:
poor socio-economic conditions (2). Diabetic foot
Diabetic foot infection is a common cause for complication imposes a huge challenge on physical
hospital admission among diabetic patients and most condition, health care cost and socioeconomic bur-
expensive in India. In the past decades lower limb den to both patient and also to the nation.
amputation is reduced to 50 percent, through proper
diabetic foot care and management of diabetes along
with proper foot care. Foot ulcer can be attributed to Risk of Amputation:
several social and cultural practices. Non healing ulcers In India foot infection is considered as a significant
cause severe and might leads to the amputation of cause of amputation (3).It has been estimated that up
toe, foot or a part of leg. Apart from glycemic control, to 50% of all non-traumatic lower limb amputations
an appropriate dietary pattern and management of are performed on diabetic patients(4). In diabetic
personal habits plays a major role in preventing foot patients, foot problems is considered as the major
ulcers. Further in order to manage neuropathic foot, a contributing factor towards increased morbidity and
prompt and regular inspection and examination of the mortality and further the economic impact of foot dis-
neuropathic foot and treatment of deformities, ulcers, ease is substantial. The prevalence of diabetic foot
and infections are required. All diabetic patients have complications has been observed to be higher in ru-
to examine the potential foot problems once in a year ral population than in the urban settings (5), The dia-
irrespective of symptoms. Early recognition of these betic foot scenario is worsen as the rural areas lacks
problems and proper healthcare resources specifically in managing
diabetic foot.
the ability to adapt the appropriate/ therapeutic foot-
wear to reduce the pressure peaks are key element Foot problem in diabetic patients is due to loss of
in the management of diabetic foot. sensation, decreased blood flow to the vessels, injury
and infection which leads to deformities, abnormal
Introduction: pressure dynamics and foot ulcer. The state of isch-
Globally diabetes and its co morbid condi- emia immune compromised condition can leads to
tions pose a major threat on public health resources, the rapid spreading of infection.
when considering the population growth and increas-
ing prevalence of diabetes, diabetes burden in India Signs and symptoms of Diabetic Foot:
would become enormous. Among other complica- Patients with Diabetes may develop various foot re-
tions, diabetic foot amputation is a frequent com- lated problems; even the minor problem may worsen
plication in developing countries like India. Patients and resulted in serious complications.
spend higher percentage of their income towards the
hospital admission when compare to patients without Inflammation is considered as one of the earliest sign
foot complication (1). It is due to the fact that among of tissue injury.
Indian population, diabetic foot disease is influenced Pain is the major natural warning system which alerts
by socio-cultural factors such as the prevalence of the patient to take action.
barefoot walking, lack of awareness on diabetic foot
complications, and lack of diabetes care facilities and Monitoring the temperature of the skin reduces the
risk of developing foot ulceration among high risk

Cardio Diabetes Medicine