Diabetes mellitus, more commonly referred to as Diabetes is a lifelong disease which is known to have affected more than 150 million people (5.5 percent of all the adults) around the globe. This disease, which is characterized by high levels of Glucose in the blood, can lead to serious complications, if not properly controlled. Diabetes can potentially affect almost all vital organs of the body. One of the most common Diabetes- related complications that account for majority of Non-traumatic lower extremity amputations is Foot Ulcers. It has been estimated that Diabetic patients have a 15 % risk of developing Foot Ulcer in their lives. The risk of lower extremity amputations due to Foot Ulcer in Diabetics is about 15 to 46 times higher than in Non-Diabetic people.
What is Foot Ulcer?
Foot ulcer refers to open wounds or sores that occur in the lower part of the legs or the feet. The Ulcer may first appear as a small wound or cut in the skin. Since the healing process is impaired in Diabetic patients, these wounds may become infected, leading to the destruction of the soft tissues and bones of your feet. Foot ulcer in Diabetics demands for immediate treatment, as otherwise it can finally lead to amputation of the affected leg.
Risk factors of Foot ulcer in Diabetics
There are certain factors that increase the risk of Foot ulcer in Diabetics. These risk factors include:
- Increase in age
- Poorly managed Diabetes
- How long the patient has been suffering from Diabetes. The longer the duration of Diabetes, the higher will be the risk of Foot Ulcers
- Peripheral Neuropathy
- Peripheral Vascular Disease
- Trauma to the foot such as wounds, cuts, bruises, insect bites, lacerations and burns
- Deformities of the foot such as hammertoes, bunions etc
- Previous incidence of Foot Ulcer
- Wearing poorly-fitting foot wear
- Untreated Calluses
- When compared to females, the possibility of having Foot Ulcers is doubled in males
- Restricted mobility of the joints
- High plantar foot pressure
Causes
There are several factors that lead to the development of Foot ulcer in Diabetics. Of all these factors, the most common one is trauma to the foot that manifest in the form of cuts, bruises, wounds, burn injury, Calluses, insect bites and injury due to penetration by sharp objects. The other causes of diabetic Foot Ulcers include
- Peripheral Neuropathy – This condition, which accounts for almost 90% of diabetic Foot Ulcers, is caused by the damage to the Peripheral nerves.
- Peripheral Vascular Disease – In this condition, the lower extremities of the body experience reduced blood flow. About 35% of Diabetic Foot Ulcers can be attributed to Peripheral Vascular Disease.
- Infection – Since wound healing is impaired in Diabetics, even small cuts or bruises may end up being infected with bacteria. The risk of amputation increases considerably if the infection spreads deeper into the underlying tissues and bones.
Symptoms
Due to poor blood circulation and Peripheral nerve damage, most cases of Diabetic Foot Ulcers are painless. The symptoms of this condition start with redness, irritation and blistering of the skin. If left untreated, the condition may worsen into infections with draining of pus and liquid. The symptoms of Diabetic Foot Ulcer include:
- Redness and swelling
- Skin lacerations
- Discoloration of the skin
- Disfigured and yellowish toe nails
- Pain or burning sensation
- Cold feet
- Drainage of pus having a foul odor
- Weakness
- Difficulty moving the foot
- Recurring muscle cramps or pain
- Fever and chills
How is Foot ulcer in Diabetics treated?
Early diagnosis and timely treatment are crucial factors that determine the prognosis of the disease. Treatment for Foot Ulcer mainly aims at obtaining wound closure, relieving foot pressure (offloading), eradicating infection and managing ischemia. In addition to these treatment methods, it is also important for the patients to control their blood sugar levels in order to avoid complications and to reduce the risk of amputations.
Prevention
Foot Ulcers in Diabetics can be prevented to a large extent by
- Monitoring and regulating blood sugar levels
- Using shoes that are pressure-relieving
- Maintaining proper foot hygiene
- Avoiding ill-fitting foot wear
- Inspecting your feet regularly for cuts or wounds and attending to them immediately , if noticed
Conclusion
Identification of the risk factors, proper foot care, regular foot examination and appropriate care of cuts and wounds are extremely important in preventing Foot Ulcers. Even if Foot Ulcers develop despite taking precautionary measures, early diagnosis and treatment of the condition can help to reduce the possibility of amputations.
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