Kathmandu:

If you are suffering from diabetes, you may face a variety of complications if you are not careful. One of the most important complications is the development of a diabetic foot ulcer. High-heeled, ill-fitted and tight shoes may cause diabetic foot ulcer.

In our country, the widely prevalent practice of walking barefoot has further added to the woes of diabetics. A diabetic person in our country is not advised correctly what to do in case he receives injury to or develops a blister on his foot. If a diabetic patient develops ulcer on his foot, instead of consulting a vascular or a cardiovascular surgeon, he goes to a general surgeon. If the ulcer does not heal, he then goes either to a skin specialist or a homeopath. This endless futile exercise ultimately leads to amputation and loss of foot.

Why are diabetic patients susceptible?

The pure blood carrying pipes (arteries) on the legs of a diabetic patient get narrowed due to two reasons: first, thickening of wall on account of microangiopathy and, second, due to deposition of fat, cholesterol and calcium inside the artery. The process of deposition of fat and cholesterol inside the artery of a diabetic is much faster than that in a normal non-diabetic person. Early narrowing of arteries in the leg results in decreased blood flow to the foot leading to ulcer.

Cause of gangrene:

Another important reasons of development of gangrene in diabetic foot ulcers is inadequate supply of oxygen - rich pure blood to feet due to narrowing of its leg arteries. In such a situation, even a minor infection spreads very fast and reaches alarming proportions causing amputation.

How to cure foot ulcer:

Constant watch over blood supply of the foot becomes essential component of therapy.

Proper care of foot and prevention of infection at all cost becomes mandatory. Control of blood sugar is very important.

A patient must treat herself in a hospital where facilities for Doppler study and angiography are available. Sometimes the ulcer becomes so complicated that removal of the gangrenous and infected part of the foot remains the only option. This is called digital amputation.

Prophylactic measures:

1. Must get your legs and feet checked up once by a vascular or a cardiovascular surgeon.

2. Always keep your feet dry and clean.

3. Never walk barefooted at any time of the day, even inside the house.

4. Always wear well-fitted, soft and comfortable shoes. .

5. Daily inspect your feet for appearance of any blisters.

(Dr Pandey is senior vascular and cardiothoracic surgeon at Indrapastha Apollo Hospital, New Delhi)