For diabetics, foot care saves lives and limbs

Diabetes is a disease in a class of its own. While it is non communicable because it isn’t infectious, it can be inherited from one’s parent.

Beyond this scare, though, is the fact that the condition can be prevented because, as Diabetologist/Medical Director of Rainbow Specialist Hospital, Dr. Afokoghene Isiavwe notes, diabetes is a disease that thrives mainly on wrong dietary habits once the genetic factor has been ruled out.

Experts describe diabetes as a group of metabolic diseases in which the person has high blood glucose (blood sugar), either because insulin production is inadequate or non-existsent (type 1 diabetes), or because the body’s cells do not respond properly to insulin (type 2 diabetes), or both.

If the high blood glucose levels are not controlled, Isiavwe says, as time goes on, the nerves, kidneys, eyes, and blood vessels can be damaged, while the disease can also decrease the body’s ability to fight infection.

Isiavwe says diabetes is a long-term condition that could only be managed with the assistance of highly skilled physicians because of its debilitating effects on the lives of those who have the condition.

She laments that the commonest form of this condition – type 2 diabetes – is typically a progressive disease, as it gradually gets worse, while the patient will probably end up having to take insulin injection for a lifetime.

Risk factors

“Overweight and obese people have a much higher risk of developing type 2 diabetes, compared to those with a healthy body weight,” Isiavwe warns; adding that individuals who have much belly fat (or abdominal obesity) are especially at risk. “This is because being overweight causes the body to release chemicals that can destabilise the body’s cardiovascular and metabolic systems,” the specialist doctor counsels.

Worse still is the problem of being physically inactive and eating the wrong foods. Indeed, scientists at the Imperial College, London, in a study published in the journal Diabetologia, warn that drinking just a bottle of soft drinks daily can raise your risk of developing type 2 diabetes by a whopping 20 per cent!

Isiavwe says the risk of cardiovascular disease is much higher for a diabetic, and that it is crucial that blood pressure and cholesterol levels are monitored regularly.

Know the symptoms

She says that most common diabetes symptoms include frequent urination, intense thirst and hunger, weight gain, unusual weight loss, fatigue, cuts and bruises that do not heal, male sexual dysfunction, numbness and tingling in hands and feet.

Diabetes foot

While every symptom of diabetes is a cause for concern, one big problem with diabetes management is what is technically called the “diabetes foot syndrome.”

Isiavwe says diabetic foot ulcer is a major complication of diabetes mellitus, and probably the major component of the diabetic foot.

The physician notes, “The condition occurs in 15 per cent of all patients with diabetes and is responsible for more than 84 per cent of all diabetes-related lower-leg amputations. Without early and optimal intervention, the wound can rapidly deteriorate, leading to amputation of the affected limb.

“Indeed, it has been estimated that every 20 seconds, a lower limb is amputated due to complications of diabetes. Therefore, early presentation and compliance with treatment are key to successful treatment.”

The diabetologist says when it comes to diabetes foot problem, prevention is better than treating it, hence the need for public enlightenment in that regard.

The reason is simple: when the nervous system is damaged as a result of uncontrolled blood sugar levels, Isiavwe says, the diabetic may not be able to feel sensations in his or her feet properly.

“At this level, normal sweat secretion and oil production that lubricates the skin of the foot may be impaired; and the problem can lead to abnormal pressure on the skin, bones, and joints of the foot during walking. All these may result in the breakdown of the skin of the foot, and at that stage, sores are very likely to develop,” the physician notes.

The American Diabetes Association adds, “Damage to blood vessels and impairment of the immune system from diabetes make it difficult to heal these wounds. Bacterial infection of the skin, connective tissues, muscles, and bones can then occur.

“These infections can develop into gangrene. And because of the poor blood flow, antibiotics cannot get to the site of the infection easily. Often, the only treatment for this is amputation of the foot or leg. If the infection spreads to the bloodstream, this process can be life-threatening.”

Save your limbs and life

But then, who wants to go about with one or no limbs at all! Isiavwe warns that foot care in diabetics matters a great deal because by the time the foot becomes diseased in a diabetic patient, so many internal organs would have been affected; and if speedy, effective and deliberate care is not sought and obtained, apart from the fact that the foot may be amputated, the patient might die.

Isiavwe explains, “Foot wound can be the result of simple accidents, or just of a knock on the tip of a toe from inside the shoe or against a hard object. However, foot ulcer in a diabetic patient is a testimony that so many things have gone wrong in the body, because it may be due to poor blood circulation as a result of damaged blood vessels (diabetic angiopathy) or because of lessened ability to feel pain (diabetic neuropathy).

“Treatment may be unsuccessful if patient comes to the hospital after so much damage has been done. And when the battle against infection is unsuccessful and the wound spreads, amputation of toes, foot, lower leg or the whole leg may be necessary. So, the best way to receive care is never to manage wound at home but to see the doctor immediately you notice a wound on your foot, however insignificant it might seem.”

The bottom line

The physician counsels you to check your feet every day. “Inspect the tops, sides, soles, heels, and between your toes. Look for dry and cracked skin, blisters or sores, bruises or cuts, redness, warmth, or tenderness, firm or hard spots. If you cannot see well, ask someone else to check your feet,” Isiavwe advises.

PUNCH.