What is Diabetic Foot ?

Diabetics develop the clinical condition called the diabetic foot, which develops due to nerve damage of the foot & leads to loss of sensation, impaired blood supply & loss of fatty tissue. This makes the diabetic foot prone to injuries. This leads to formation of non-healing ulcers & gangrene, which ultimately results in amputation.

What causes Diabetic foot?

Neuropathy induced by chronic diabetes is the root cause of Diabetic foot. Loss of sensation caused by diabetic foot leads to uneven pressure areas on plantar side of foot.
Direct mechanical disruption of tissue (eg patient stepping on nail while barefoot abruptly breaking the skin barrier)
Small amount of force that is sustained over time that leads to ischaemia (eg tight shoe may lead to breakdown of bunion site)
Moderate amount of force that is repeated over and over leads to inflammation and enzymatic autolysis of tissue (eg plantar metatarsal ulceration).

What are the symptoms of Diabetic Foot?

Loss of sensation in feet.
Loss of fatty pad at the plantar side of the foot.
Non healing cracks and wounds at feet.
Elevation in skin temperature.
Bleeding corns or calluses.

How to prevent Diabetic Foot?

Diabetic foot is a condition which can not be prevented but if taken care timely then the damage caused by diabetic foot can be prevented.
A patient of diabetes must check his or her feet regularly.
Diabetic patients must use comfortable and appropriate foot wears.
Diabetic foot patients must keep their feet clean and dry.
Patients must use some true medical grade silicone pressure offloading devises to protect their feet from localized elevated plantar pressure.

What is the treatment of diabetic foot?

Diabetic foot encompasses a management program since it can not be permanently cured.
Along with some pharmacological treatment mechanical offloading support systems are used to manage Diabetic Foot.
Amron Silicone Insoles are an integral part of Diabetic foot care management.
Amron Health Socks, specially designed for Diabetics help in minimizing the risk of foot compliactions.

If left untreated?

If Diabetic foot is not attended timely, it leads to the formation of foot ulcers which are difficult to heal.
Further ulcers may develop in to gangrene and foot amputation may be a last option.
Foot Amputation is very common among the patient of diabetes. Rather world wide 30% of total foot amputations is of diabetics only.

What is Diabetes ?

Diabetes, a systemic disease resulting in an elevated blood sugar level, affects approximately 33 million Indians.Diabetes results from either the body’s decreased production of insulin or when the body cannot properly utilize insulin. Blood glucose levels then rise, bringing on symptoms.

There are two types of diabetes:

Type I is hereditary and often starts at an early age. These sufferers manufacture little or no insulin, and must inject insulin into their bloodstream to control their blood glucose level.
Type II, or adult onset diabetes, typically occurs in the obese. The insulin they produce is either not enough or does not work properly. Type II diabetes; however, can be managed with diet, exercise and oral medication. Occasionally, an injection of insulin may be required.

What are the common symptoms ?

Diabetes can be a silent disease affecting many other tissues & patient develops certain symptoms

Nerve Damage: Diminished sensation or the inability to feel pain, associated with numbness or tingling of the hands or feet. The feet can easily become infected when sufferers do not notice they have a pebble in their shoes, for example.
Peripheral Vascular Disease or poor circulation leading to ulcers, infections and other serious

foot conditions: Diabetes often affects the blood vessels, reducing the amount of blood flowing to your legs and feet. This makes it hard for a sore or infection to heal. These two conditions can work together to cause a foot problem, or to make it harder for a foot condition to heal.
Decreased resistance to infection.
Kidney failure resulting in dialysis.
Increased thirst and hunger.
Dry mouth and frequent urination.
Unexplained weight loss or gain.

What is Diabetic Neuropathy ?

Diabetic Neuropathy: Diabetes is a very serious disease, and like many serious diseases, complications often arise over time. One of these complications is known as diabetic neuropathy, which develops following damage to the specific nerves in the peripheral nervous system, the nerves connecting the brain and spinal cord to the rest of the body.

Types of Diabetic Neuropathy:

Diabetic neuropathy, a complex deformity, can cause the development of the following three types of neuropathy in people with diabetes:

Diminished sensation and the inability to feel pain.
Numbness or tingling in the feet.
Abnormal pain, or pain for no reason at all.
Deep-seated pain and/ or an unusually unpleasant increased sensitivity to pain.
Difficulty regulating body temperature and inability to distinguish between hot and cold temperatures.
Slower response time/ decreased muscle strength.

Motor Neuropathy: Also known as, focal neuropathy, this condition is characterized by the impairment of the nerves – such as those in the thigh or foot – which control muscles, resulting in mechanical deformities and imbalance.

When these nerves in the foot breakdown, natural foot stabilizers also deteriorate, leading to such conditions as hammertoes with corns and calluses.
When the more proximal muscles are affected, leg muscle weakness, muscle imbalance and further abnormalities in the feet, including Charcot Foot, can result.

Autonomic Neuropathy: When the nerves that control involuntary (autonomic) functions of your body are affected, you could have a type of diabetic neuropathy called autonomic neuropathy. Involuntary functions affected include:

Sweat glands
Many people experience a dramatic increase or decrease sweating. Skin can dry out fast either way, leading to decreased skin pliability and, eventually, cracked and/or bleeding feet and infection.
Digestion (gastrointestinal dysfunction)
Urination (bladder problems)
Change in heartbeat, peripheral vascular disease with edema (swelling) and erythema (redness)
Some sexual functions (impotence)

Loss of Body fat: Fatty pad becomes thinned or completely absorbed; it cannot protect skin properly from normal bone pressure.

When You Have Diabetes - 10 Steps to Healthy Feet

Step #1. Have your doctor check your feet regularly-See your family doctor regularly to be sure your diabetes is in good control. Have your doctor look at your feet at every visit.

Step #2. Wear the right shoes and diabetic socks-Don't wear shoes that fit too tightly or pinch your feet. Choose thick cotton socks and well-cushioned shoes with plenty of room in the toes. (Look for shoes with a high toe box.) They will help keep your feet healthy. Never go barefoot.

Step #3. Check your feet every day-Look at your feet very carefully every day to be sure you have no cuts, scrapes or blisters. Look at every part of your foot, even between your toes.

Step #4. Treat cuts, scrapes and blisters-See your doctor if a wound does not heal-If you get a small cut, scrape or blister on your foot, wash the area gently with soap and water. Don't break the blister. Put an antibiotic cream on the wound several times a day. If the wound does not heal in a few days, see your doctor

Step #5. Keep your feet clean-Gently wash your feet with soap and water every day. Pat your feet dry. Put on a moisturizing cream or ointment (for example, petroleum jelly). Don't put too much moisturizer between your toes, however.

Step #6. Cut your toenails correctly-Cut your toenails straight across the top, not curved at the sides, to prevent ingrown toenails. Ask your doctor for help if your nails are too thick or if they crack when you try to cut them.

Step #7. Treat athlete's foot-Athlete's foot is more common in people who have diabetes, and it can cause problems. If you have athlete's foot, wear a different pair of shoes every other day. This lets your shoes dry out. Always wear absorbent cotton socks. See your doctor if over-the-counter treatments do not clear up your athlete's foot.

Step #8. Get proper treatment for thickened skin, calluses and corns-Many people with diabetes get thickened skin, calluses or corns over the bony spots on their feet. Don't trim or cut these spots at home with razor blades or other sharp tools. Ask your doctor how to treat these spots.

Step #9. Avoid heating pads and hot water foot soaks-Because diabetes can hurt the nerves in your feet, you might not be able to tell if something is hurting your feet. It is best not to use heating pads or hot water soaks, since you could burn your feet without knowing it.

Step #10. Take action to improve your circulation-High blood pressure, high cholesterol levels and smoking can harm the circulation in your feet and keep sores from healing. Ask your doctor for help if you have any of these problems.

Types of Diabetic Neuropathy:

Foot orthoses, i.e. , orthotic shoe insoles serve as an important first line of defense for effective prevention & treatment of diabetic foot.

This reduces plantar pressure (sole of the foot) & redistributes the foot pressure.

Off loading mechanism of biomechanically designed silicone insoles helps in redistributing the load on load bearing points of foot.

Offer excellent shock absorbing capacity.