Sitting for long with no breaks? Watch out for diabetic foot

Growing cases of Type 2 diabetes which can cause diabetic foot in working professionals is a fallout of the pandemic says a study by Johns Hopkins School of Medicine If left unmonitored the condition raises the risk of gangrene and amputation say experts In a diabetic foot a person loses the sensation in the body part thus failing to notice cuts and blisters The seemingly minor wounds trigger bigger problemsDr Wiqar Shaikh Professor of Medicine Grant Medical College and Sir JJ Group of Hospitals said a study published in the International Journal of Clinical Practice UK had found a substantial rise in Type 2 diabetes during the COVID outbreak Another study done in Kolkata published in the Diabetes and Metabolic Syndrome pointed to a similar situation in IndiaQuoting the findings by the Johns Hopkins School of Medicine he said a sedentary lifestyle raises chances of high blood pressure diabetes heart attacks cancers and falls ldquoA study from Italy published in Practice Update pointed to a threefold increase in the incidence of diabetic foot and resultant amputations during the pandemic A study published in the Sports Med and Health Sciences in May 2020 also had concluded similar risksrdquo he saidldquoDiabetes mellitus is assuming epidemic proportions in our country More and more younger individuals are being diagnosed as diabetic Diabetes over a period of time typically affects both the nerves and blood vessels thereby making feet vulnerable to injury and infection Diabetic foot is one of the most dreaded and morbid sequels Untreated or improperly managed it can lead to spreading lifethreatening infections requiring major amputations of the lower limbrdquo said Dr Ketan Vagholkar Professor of Surgery at DY Patil Medical CollegeA diabetic should regularly visit a surgeon to check the extent of both vascular and nerve involvement ldquoStrict control of blood sugar properly formulated diet and exercise will help control blood sugar levels This should be followed by specific dos and donrsquots to prevent foot infection Minor injuries and infections of the feet need to be treated by a specialist surgeon at the earliest Rigorous control of blood sugar levels along with a periodic assessment of footwear and the use of specialised protective footwear tailormade for diabetics can help prevent the development of foot lesionsrdquo explained Dr VagholkarExpertrsquos adviceDr Chandrakant Rao a diabetologist who has done extensive research on the disease said ldquoDiabetic damage to nerves especially of the feet is very common but often missed Hence it is called the lsquoCinderella of diabetes complicationsrsquo because neither the patient nor the doctor notices it at early stages in a busy OPD practice Patients may experience burning pricking sensation numbness tingling or a total loss of sensation Arterial blocks lead to calf pain on walkingrdquo Dr Rao saidDiabetics who smoke and have high BP and high cholesterol are at great risk he said ldquoAbout 85 per cent of neuropathy patients can prevent an ulcer and for those who develop ulcers 85 per cent can prevent an amputation with proper management The three most important aspects of preventing foot problems in diabetes are good glucose control HbA1c lt7 per cent daily foot care and protective footwearrdquo Dr Rao explained lsquoHe had total loss of sensation in his feetrsquo A farmer from Pune was suffering from a nonhealing diabetic foot ulcer for two years ldquoAs he had a total loss of sensation in his feet he would walk without footwear We devised lowcost offloading footwear along with diabetes control which led to complete healing of his ulcerrdquo said Dr Rao A diabetic who was also a chronic smoker used to have pain in his calf on walking which reduced at rest He had a small cut over his great toe which did not heal for a week ldquoOn the seventh day he noticed the toe had darkened There was no pulse in his foot and there was impending gangrene Tests revealed a blockage in the artery Urgent stenting and blood thinners prevented amputationrdquo said Dr RaoFoot care Look for swelling redness cuts Avoid barefoot walking hot fomentation rigorous massages tight shoes cutting nails too deeply filing nails is safer Diabetics should wear specially designed footwear with MCRbased insolesThis can prevent ulcers in over 9537 patients said Dr Rao