Health - Foot asleep?Wake up to Diabetes

NEW DELHI: If your foot often falls asleep and there are cuts or bruises on them that cause no sensation, brace yourself - it may be a case of
diabetic foot.

With World Diabetes Day falling on Friday, experts have a word of advice. Leading a life of discipline and being cautious with one's feet is the key to living with diabetes and dealing with the potential risk of gangrenous infection is simple, they say.

"Diabetic patients are often lazy about basic instructions - following a disciplined routine of taking medicines and regular exercises as prescribed. These are essential to keeping the circulation of blood and sugar levels in check," said Ashok Jhingan, diabetologist and chairman, Delhi Diabetes Research Centre, said.

Diabetes is a growing problem on the Indian subcontinent and in the Middle East.

According to the International Diabetes Federation (IDF), there were an estimated 40 million people with diabetes in India in 2007 and this number is predicted to rise to almost 70 million people by 2025.

"When a normal person wakes up in the morning, he goes to the mirror to look at his face. But a diabetic needs to look at his feet with the same care," Jhingan said.

This is because the symptoms and signs of a diabetic foot include numbness or tingling in the feet, persistent sensation of cold feet, ulcerations on the foot or the toes.

"One must also be wary of small cuts or burns that can develop into gangrene or deformities on the toes and the foot," Jhingan explained.

A recent study compiled by Kushagra Katariya, CEO Artemis Health Sciences and cardio thoracic surgeon, ahead of World Diabetes Day on Nov 14, found that approximately 5% of diabetics develop foot ulcers and 12 percent develop poor leg and foot circulation and every 30 seconds a lower limb is lost to diabetes.

"Unfortunately as a result of these problems, a diabetic is 15 times more likely to have an amputation of the leg than a non-diabetic," Katariya said.

Diabetic foot problems can occur at any age and after any amount of time following someone being diagnosed as a diabetic.

"However, most patients with diabetic foot problems are older, as circulation gets poor with advancing age," he added.

It is important for diabetics to get their feet regularly checked by a healthcare professional that specialises in this field, feel doctors.

"If there is a small infection, it can be controlled before it develops into a gangrene-like threat - the dead skin can be scraped, aspirin like drugs for speeding circulation to wounded areas can be prescribed, but first the diabetic must check his feet and be careful," Jhingan observed.

In some cases, the blood circulation in diabetes patients is so bad that it can cause vascular blockages. These can be removed surgically but also
through an angioplasty or laser.

"The doctor may order simple tests such as a vascular ultrasound to check the circulation in the legs. More advanced tests may include a CT-Angio or an MRA to look at the vascular supply," said Katariya.

Many diabetic foot problems can be nipped in the bud by raising patient awareness to potential problems - watch your weight, keep blood sugar levels in control and get regular checkups.

"Diabetics should always buy footwear in the evenings," Jhingan quipped, "not in the mornings as poor blood circulation causes the foot to swell in evenings - the shoes should not be tight or smaller. Comfortable soft soled footwear should be worn."

In winters, the diabetic foot is often likely to be regarded as a chill bite.

"In which case the patient should be doubly cautious - keep warm but avoid prolonged exposure to hot water - this can cause bacterial infections and non-healing ulcers in diabetic patients, as their wounds take longer to heal. Due to loss of sensation in their feet, diabetics often don't come to know about such injury early enough," Jhingan averred.

In India almost 40,000 legs are amputated every year due to diabetes alone.

"Due to a gradual decrease in vision, diabetic patients tend to wound themselves. And due to a simultaneous loss of sensation in the feet, they do not feel the pain and hence the wound is ignored, causing prolonged infection - the limb then has to be amputated," Jhingan said.