Diabetes is a common health problem. In some countries, such as India, diabetes affects as many as 10-15% of adult urban population, which indicates its prevalence in such countries. Diabetes is a metabolic disease where glucose metabolism is abnormal.

What is diabetic foot ulcer?

Diabetic Foot Ulcer is a major complication of diabetes. Other major complications of diabetes include, diabetic retinopathy (affect eyes and can cause blindness), diabetic nephropathy (affect kidneys and can cause renal failure), diabetic neuropathy (affect nervous system) etc. Diabetic Foot Ulcer affects approximately 15% of diabetes patients, especially among those with uncontrolled blood sugar level. Diabetic foot ulcer is a major reason of lower leg amputations.

In diabetic individuals, would healing (even minor wounds healing is delayed) is delayed. But, for diabetic individuals, due to micro and macro-vascular complications, wound healing is delayed or there may not be any wound healing at all (failure of wound healing, which is a natural process of body’s defense mechanism).

How to prevent diabetic foot ulcer and diabetic foot?

Prevention of diabetic foot ulcer is multi-pronged approach and include, frequent review by chiropodist (all diabetic individuals should get reviewed by chiropodist at least 2 times a year), use of diabetic socks and shoes, and maintenance of good foot hygiene. Avoidance of injury to foot (as well as legs) is also important aspect of prevention of diabetic foot. If there is minor injury to foot or leg, treat it optimally to prevent diabetic foot ulcer.

• All diabetics should be given foot care education and importance of foot care for prevention of diabetes should be thoroughly explained. Regular foot care surveillance should be done.
• Use of special footwear by diabetic individuals. Ideally foot wear (special footwear) for diabetic individuals should be custom made to correctly fit. Persons with foot deformity also may require custom made footwear. Exact fitting well-chosen and well-fitting athletic shoes also can be used (although there is no comparative study regarding effectiveness of custom made shoes and well-chosen and well-fitting athletic shoes in prevention of diabetic foot ulcer).
• The most important way to prevent diabetic foot is tight control of blood glucose level. The blood glucose level should be kept as close to normal as possible to prevent diabetic foot ulcer. Well controlled diabetes (blood glucose within normal range) is the best way to prevent diabetic foot ulcer.

Risk factors of diabetic foot:

Uncontrolled blood sugar level is the most important risk factor of diabetic foot ulcer. Hence, most important preventive measure of diabetic foot ulcer is well controlled blood sugar level.

• Diabetic neuropathy is a major risk factor for development of diabetic foot ulcer. In peripheral neuropathy there is loss of pain sensation as well as feeling in the toes, feet, legs and arms due to distal nerve damage and low blood flow. Due to lack of pain or feeling, blisters and sore formation is common in these areas. Due to lack of feeling or pain sensation, minor injuries goes unnoticed and eventually become portal of entry of bacteria and initiate diabetic foot ulcer.