Diabetic Foot: Everything you should know

High blood sugar levels in diabetes damage blood vessels, increasing the risk of decay of foot. It may also result from an increased risk of foot infection. Body's immune system, specifically the white blood cells in blood protect the body against infections. However, the immune system of patients with diabetes mellitus is unable to ward off invading organisms. In addition, blood vessels of a diabetic patient are often damaged due to excessive sugar running through the veins.

Diabetes and foot infections

Common sensitive areas of the diabetic patient's body are skin, feet, lungs, urinary tract, genitals and mouth. Skin infections, in particular, are detected more commonly due to their visibility. Diabetics are prone towards foot infections as the feet are organs most commonly exposed to injury in the course of routine life. Diabetic foot infections are commonly seen in diabetic patients also suffering from associated eye or kidney problems. Foot infections in diabetic patients may begin as small ulcers, leading to invasion of deeper tissues, gangrene or affect the underlying bones and also enter the bloodstream.

Diabetes complication: Gangrene (Diabetic foot)

Gangrene is a serious complication of diabetes that results in decay or death of a part of foot. It results from the exceedingly high levels of blood sugar (hyperglycaemia), a condition that hardens the walls of arteries supplying the foot and damages the nerves in the area. This reduces the blood supply to the foot, which over a course of time begins to decay as gangrene sets in. The increased susceptibility of a diabetic patient's body to infections also increases the chances of gangrene due to infection of the foot.

Types of diabetic foot

Diabetic foot is classified into the following based on Wagner's classification:

1. Grade 0 (skin over foot is intact)
2. Grade I (surface ulcer)
3. Grade II (deep ulcer)
4. Grade III (deep abscess or osteomyelitis)
5. Grade IV (gangrene of front of the foot)
6. Grade V (gangrene in the heels and back of foot)

Treatment of diabetic foot

Laboratory tests confirm if the condition is a result of infection and also identify the causative organism, in which case antibiotics are prescribed to the patient. Surgical treatment like debridement and routine dressings are crucial for promoting healing. Extremely severe cases of gangrene may require amputation of the gangrenous area. Amputation begins by first removing the toes; the remaining foot may also require amputation if infection is not limited.

Prevention of diabetic gangrene

Gangrene in diabetic patients can be prevented by closely monitoring the blood sugar levels. A diabetic patient must also take adequate care of his/her feet:

1. Patient must maintain good foot hygiene and keep feet dry and warm as much as possible.
2. Feet must be rested often.
3. The patient can wear soft pads on the feet soles to prevent injuries. It is best to avoid tight, high-heeled shoes and flip-flops.
4. Patient must inspect feet daily for any sign of infection of injury, major or minor.

Sources:Image courtesy of [satit_srihin] / FreeDigitalPhotos.net"Diabetes and gangrene," https://www.news-medical.net/health/Diabetes-and-gangrene.aspx"Diabetes, Foot Care and Foot Ulcers," Patient.co.uk, https://www.patient.co.uk/health/diabetes-foot-care-and-foot-ulcers"INFECTIONS AND GANGRENE IN DIABETES MELLITUS," https://www.diabetesmellitus-information.com/diabetes-infections.htm