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For a healthy foot forward Foot care is crucial for diabetic persons because over 40 per cent of lower limb amputations are related to diabetes
It is a recognised fact that better foot care, including especially designed orthotics and insoles, can prevent foot amputations in diabetics. However, this dimension of diabetes is little talked about in India. According to World Health Organisation, more than 340 million people in the world suffer from diabetes. With almost 60 million diabetics, India today is home to the second largest population of diabetics in the world after China. The World Diabetes Foundation estimates that 40 per cent to 70 per cent of all lower limb amputations in the world are related to diabetes and that 85 per cent of all diabetes-related amputations begin with a foot ulcer. Diabetes complications include nerve damage and poor blood circulation, referred to as neuropathy. This makes the feet vulnerable to ulcers that can be extremely dangerous. Many people with diabetes lose sensation in their feet and often fail to recognise skin injuries that may develop into infected ulcers. It is often difficult to treat such skin sores which in some people can lead to gangrene and necessitate amputation to save life. Estimates by the Word Diabetes Foundation also suggest that about 40,000 lower limb amputations take place in India each year, and a large number of them are due to diabetes-related complications. Along with diabetes prevention, it is hence important to focus on diabetes management mechanisms that include proper foot care. In cases when amputation cannot be avoided, efforts should be made to make the lives of the patients easier with advanced prosthetics. It is important to emphasise that proper diabetes management and careful foot care can help prevent foot ulcers. In developing countries, a major cause of foot ulcers is unsuitable shoes as well as the habit or the need to walk barefoot. What is diabetes Diabetes mellitus is a chronic disease that may lead to a range of complications, including disability and early death. Insulin is a hormone produced in the pancreas that helps the body to convert glucose from food into energy. Diabetics basically lose control over this hormone and hence on the level of glucose in the blood. People with diabetes either fail to produce enough insulin (type 1 diabetes) or their bodies lose their capacity to use the insulin effectively enough so as to convert glucose to energy (type 2 diabetes). This is an irreversible condition but effective management can keep the ailment in control. In developing countries, a major cause of foot ulcers is unsuitable shoes as well as the habit or the need to walk barefoot. Diabetic foot Diabetic foot is one of the complications caused by diabetes. Diabetic foot is a term used to denote feet-related complications that can arise in a person suffering from diabetes, including infection, ulcers, sores and neuropathy. Neuropathy or nerve damage leads to loss of sensation and skin injuries often go unrecognised because of this. Due to nerve damage, sometimes changes may also occur in the shape of the feet or toes. The skin of your foot may also be affected due to diabetes. It may become dry or crack, and this may lead to infection. In extreme cases, these situations may necessitate amputation to prevent a gangrenous wound from poisoning the entire body. Sometimes, a non-healing ulcer that causes severe damage to tissues and bone may require surgical removal. Amputation may be minor (removal of toes of feet) or major (above or below the knee amputation of the leg). Among people who have diabetes, amputations are reported to be 15 times more common than among other people. Neuropathy makes your foot insensate to pressure. This is a dangerous situation as it can lead to a micro-trauma and joint injury to your foot which is likely to cause harm. Foot management is crucial for diabetes management Take sores and injuries seriously: There is no way an injury or a skin sore can be ignored. If a foot sore hasn’t healed within a normal duration, immediately contact your doctor. Shoe insoles are foot support devices designed to be worn inside the shoe to lend support to your foot and prevent excessive pressure on one area. In India custom-made insoles are available to suit the needs of the patients. They are often made of soft foam like substance and can be slipped into your shoes to provide cushioning to your feet. These are especially designed to comfortably accommodate a foot, reduce pressure on the sole and toes and keep the feet injury free. They also relieve areas of the feet that usually take excessive pressure. Even if you have been standing or walking for a long time, insoles will provide relief to your feet. For people with diabetes, this is very crucial to prevent injury or sore. Studies and research have suggested that long-term use of foot orthoses like insoles can reduce the incidence of diabetes-related amputation. Such devices help reduce pressure on the foot and reduce the risk of sores or ulcers that may be the potential cause of amputation.
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