Regular check-ups must for diabetics to avoid foot problem

Not only must he be careful with his medications and diet, but he must also ensure his feet are not impaired by the wrong kind of shoes. “Since 2010, the doctors have also been measuring the softness of my footwear, to ensure I do not develop tears on my feet. After every check-up, I am instructed to switch to a softer pair of shoes,” he said. 

With the lack of sensation owing to nerves that begin to fail and the abnormal weight distribution on the foot causing wear and tear on the feet of diabetics, doctors feel it is essential that diabetics take extra care of their feet. 

With over 60 million diabetic patients in the country today, doctors stress on the importance of annual check-up. Dr N Thomas, Diabetologist, CMC, said, “Usually, in the case of a diabetic, the nerves begin to reduce the feeling of sensation. Muscle weakness and pain develop gradually and when neglected, can lead to amputation of toes and the foot itself.” 

At an event held at Sri Ramachandra University recently, Dr G Arun Maiya, Professor and Head, Centre for Diabetic Foot Care and Research, Manipal University, said, “Every 30 seconds, someone around the world is losing a part of one’s foot due to diabetes which can be easily avoided, with preventive checks and comprehensive treatment.” With the number of diabetics in the country increasing drastically each year, diabetic foot-care has become highly specialised. “Diabetic patients should check their foot at least once a year, those whose conditions are severe should consult once in six months and those with ulcers, once a month for preventive and corrective treatment,” he added. 

Stating that the problem can be corrected with optimally fitted special footwear with cushioned insoles, he added that many tend to remember to try the correct fitness only in the evening when the foot tends to swell a little. “Widespread awareness, early risk assessment, aggressive treatment and life style modification can prevent amputation of the limbs,” he added. When asked on the preferred type of footwear for diabetics, Dr Anjana Mohan, Diabetologist, Dr Mohan’s Diabetes Hospital, said, “A diabetic can use either the Microcellular Polimer (MCP) or Microcellular Rubber (MCR) material. It is not a measure of softness but there is actually a technology in it. Anything with MCR or MCP should be good for diabetic feet. It is prescribed because the pressure distribution becomes unequal and one develops pressure points in those areas where we add more pressure on one leg, which is a common occurrence.” Non-diabetics too exert pressure on one leg, however, there is a difference, she added. 

“In non-diabetics, when there is too much pressure in the leg, they shift the weight to the other leg or change positions. However, in a diabetic, over time, pain sensation becomes diminished, so that ability to shift to the other foot and ease the pressure point is reduced. They continue to put pressure on that foot, damaging it. This can further add more pressure on the underlying tissues and cause damage. Therefore, patients are advised to use the special mentioned footwear,” said.

* Over 61 million suffer from diabetics in India today

* It is expected to increase to 89 million in 2020 and 101 million by 2030 

* A third of diabetics at risk of developing ulcer in one foot over the course of their lifetime 

* Diabetics are at a greater risk of developing foot-related complications Morbidity and mortality associated with foot ulcers can go unrecognised by doctors and patients.