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Foot issues are common among individuals with diabetes. Consistently high blood sugar can damage nerves and blood vessels in the feet, thereby causing a myriad of foot problems that tend to worsen over time. Early intervention is essential to prevent serious complications such as diabetic foot and enhance an individual’s quality of life.
Synopsis
Risks of neglecting foot care in diabetics
If left unchecked, diabetes can cause extensive nerve damage—known as diabetic neuropathy—which may alter the shape of your feet or toes, making it difficult to find properly fitting shoes. Walking in unsuitable footwear can cause calluses to develop due to constant friction. While calluses are generally considered harmless, diabetic individuals need to exercise caution as they are most susceptible to developing peripheral artery disease (PAD), which reduces blood circulation to the legs and feet, significantly lowering the foot’s ability to defend itself against infections. This results in delayed healing.
Diabetic neuropathy also significantly reduces the capacity to perceive sensations like heat, cold or pain. Consequently, people with diabetes are frequently unaware of minor cuts, calluses or ulcers on their feet, allowing infections to worsen and potentially lead to gangrene. In severe cases, limb amputation may be necessary to prevent further spread of infection.
Signs to look out for
Although symptoms can vary depending on the specific type of diabetes-related foot condition, there are certain tell-tale signs that individuals should be mindful of. Common diabetic foot symptoms include pus or fluid discharge, foul odour, bleeding, pain and tingling, swelling, and discoloured skin or toenails. Lack of sensation often masks pain, so it is crucial for diabetic individuals to closely monitor their feet, particularly when walking barefoot.
Diabetic foot care includes simple activities like rinsing and moisturising the feet daily, making sure shoes are free of small stones and debris before putting them on, and checking the feet on a regular basis for cuts, blisters, or the presence of ingrown toenails can help avoid unnecessary complications. Trimming toenails can also be dangerous if you are diabetic, particularly if they are thick or tend to curve into the skin. Therefore, it is best to let a professional foot doctor or podiatrist perform this service to prevent any accidental cuts or scrapes.
Why early intervention matters
Sometimes, issues tend to arise despite taking necessary precautions. In such cases, it is crucial to reach out to an experienced plastic, cosmetic and reconstructive surgeon who can map out a suitable diagnosis and diabetic foot treatment plan depending on the severity of the condition. Spotting minor issues early on and taking action to manage their symptoms can prevent them from escalating into life-altering complications. For instance, in patients with neuropathy, early intervention and treatment are vital for wound healing, which can mitigate the formation of ulcers and infections that could lead to deformities or amputation— safeguarding mobility and enhancing one's overall quality of life.
Classification and management
Diabetic foot conditions fall into three main categories based on the cause of the problem:
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Neuropathic: These conditions are caused by nerve damage due to diabetes that can take various forms, including peripheral, autonomic, focal, and proximal neuropathy. Common neuropathic diabetic foot conditions include charcot arthropathy, neuropathic ulcers and fixed foot deformities such as claw toes.
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Ischemic/vascular: The main cause of ischemic types of conditions is from restricted blood flow owing to peripheral arterial disease (PAD), most common in long-standing diabetics. Examples of ischemic conditions include ischaemic ulcers, gangrene and delayed wound healing.
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Infectious: Infectious conditions occur as a result of poor wound healing and impaired immunity. Bone infections like diabetic foot osteomyelitis, cellulitis, and abscess formations are classic examples, with a diabetic foot attack indicating an acute, severe infection that requires immediate medical attention.
Charcot arthropathy, diabetic foot osteomyelitis and diabetic foot attack are three conditions that would require surgical intervention depending on the extent of damage caused. Surgery is often the primary approach considered for patients presenting with necrosis of the soft tissue, exposed bone or joint, fluid collection or abscess and those who have been offered antibiotic treatment but are either resistant or experiencing antibiotic-related toxicity.
Conclusion
Dealing with diabetic foot-related complications can be tough, but with appropriate care and treatment, they can be effectively managed. Identifying symptoms early makes all the difference. That’s why individuals with diabetes need to prioritise personal hygiene and self-care while also paying close attention to any minor changes in their bodies. Even the tiniest sore or cut—no matter how small—cannot be ignored.
The podiatric surgery department at Manipal Hospital, Millers Road, is equipped with state-of-the-art surgical and imaging equipment, assuring patients a seamless journey through surgery and recovery. Book a consultation with our expert plastic, cosmetic and reconstructive surgeon in Millers Road to explore the best diabetic foot treatment plan that suits your foot condition.
FAQ's
It is important to consider that diabetic foot conditions can be very serious without proper management as these problems can lead to ulcers, infections and in extreme cases, amputation.
Diabetic foot complications progress along 5 stages: normal foot with no complications; high-risk foot with pain, wounds or nerve damage; ulcerated foot; infected foot; and necrotic foot (with gangrene).
The type of surgery performed depends on the condition of the foot. Surgical procedures generally aim to preserve limb function and can range from simple debridement procedures that involve removing the dead or infected tissue to complex reconstructive surgeries.
Recovery time generally varies depending on the severity of the condition and the type of surgery performed. The general timeline is usually 2-4 weeks for minor ulcers, at least 6 weeks for bone infections and a few months or longer for severe ulcers.
The average cost of diabetic foot surgery can start from as low as Rs 30,000 to Rs 4,45,000 or more, depending on the stage of the condition, type of surgery required and also the hospital and city chosen to carry out the procedure. Early diagnosis and treatment are always better as they reduce overall costs while promoting faster healing and recovery.
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