Diabetes Month U.S.A.: Diabetics, watch your feet!



Many sufferers are unaware that their disease may lead to serious complications of the feet. KASMIAH MUSTAPHA writes.

DIABETES is a chronic disease which can also lead to kidney failure, cardiovascular disease, stroke and peripheral arterial disease.
Another common problem that diabetics may not be aware of is foot ailments.

The International Diabetes Federation (IDF) says foot ulcers and amputations are one of the most serious and costly complications of the disease.
Pantai Hospital Kuala Lumpur consultant physician and geriatrician Dr Rajbans Singh says foot injury is very common, especially for those who have poor control over their condition.

“Many diabetics suffer from diabetic neuropathy resulting from uncontrolled blood sugar levels. This will result in damaged nerves in the legs and feet. The patients lose most of their sensation and can’t feel pain, heat or cold. So, even if they get a cut or injure their foot, they may not realise it.

“Diabetics are also prone to infections and these can aggravate the problem. In fact, the first symptom that crops up is swelling and redness of the feet.”
Diabetics also suffer from peripheral vascular disease which causes poor blood flow in the nerve system. The low blood flow to the feet would lead to inadequate delivery of oxygen and nutrients to the foot. As such, it takes a longer time for wounds to heal.
In some cases, the patients would only seek treatment when gangrene has set in.
This is when the doctor would resort to amputation to save the patient’s life.

The IDF says between 40 and 60 per cent of all non-traumatic amputations on the lower limbs are performed on patients with diabetes, 85 per cent of diabetes-related lower extremity amputations are preceded by feet ulcers, four out of five ulcers in diabetic subjects are precipitated by external trauma and the prevalence of foot ulcer is four to 10 per cent of the diabetic population.

Dr Rajbans said foot injury occurs when a person does not wear proper footwear or has a minor cut that he is not aware of, which eventually gets infected. Unfortunately, most diabetics are seldom aware of the need to take care of their feet.

The common foot problems faced by diabetics include athlete’s foot, fungal infection of nails, calluses, corns, blisters, bunions, dry skin, foot ulcers and ingrown toenails. If left untreated, there is a possibility diabetics could lose their feet.

Dr Rajbans said to avoid foot injury, diabetics should check their feet daily and wear proper-fitting foot wear.

To prevent foot injury, diabetics should :

Control blood sugar level. Stop smoking as it can worsen blood flow problems.

Wash their feet in warm water every day and dry it well, especially between the toes. They should not soak their feet.
Check their feet every day for cuts, sores or blisters. Early treatment will prevent serious damage to feet and amputations.

Always wear closed-toed shoes or slippers. Do not wear shoes with pointed or open toes, such as high heels, flip-flops or sandals. Do not walk barefoot, even around the house. Always wear socks or stockings.

Wear comfortable, well-fitting shoes. Never buy shoes that do not fit properly, hoping the shoes will stretch with time. Nerve damage may prevent you from being able to sense pressure from ill-fitting shoes. You may need special shoes made to fit your feet.

Keep the blood flowing to the feet. Put the feet up when sitting, constantly wiggling the toes and moving the ankles several times a day. Do not cross your legs for long periods of time.

If you have a foot problem that gets worse or won’t heal, contact your doctor for advice and treatment.

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