Diabetic Foot Treatment

Diabetic foot disease is multifactorial, involving:

1. Neuropathy (Nerve Damage): The Hidden Danger

Neuropathy, or nerve damage, is one of the most common and serious complications of diabetes affecting the feet. High blood sugar levels gradually damage nerves, especially in the lower limbs, leading to a loss of sensation and reduced ability to feel pain, temperature, or injury. This silent damage means that minor foot issues can go unseen and quickly intensify into infections or ulcers, increasing the risk of amputation. Recognizing the signs of diabetic neuropathy is crucial for early intervention and limb preservation—especially in countries like India, where diabetes rates are rapidly rising.

• • Numbness or tingling: A persistent “pins and needles” sensation in the feet or toes

• • Loss of feeling: Inability to sense pain, heat, or cold in the feet, making injuries hard to detect

• • Muscle weakness: Difficulty walking or maintaining balance due to weakened foot muscles

• • Foot injuries that go unnoticed: Minor cuts, blisters, or sores that are often not felt and may worsen over time – If you do not feel much pain but do observe discoloration/swelling/discomfort no subsiding beyond 2 days – visit a doctor.

Not feeling pain is not a sign of your strength; may be sign of neuropathy.

• • Burning or sharp pains: Unexplained burning, shooting, or stabbing pains in the feet, even while at rest

Regular foot checks and proper diabetes management are especially essential for every diabetic patient.

2. Peripheral Arterial Disease (PAD): When Blood Flow Gets Blocked

Peripheral arterial disease is a serious issue for people with diabetes. High blood sugar makes the arteries in your legs hard and narrow, which limits the amount of blood reaching your feet. Without enough blood, your body struggles to deliver oxygen and nutrients, making it hard for wounds to heal and raising the chance of infection.

Some signs that you might have PAD include:

• • Cuts or sores on your feet are slow to heal or the skin on your feet or toes look pale or bluish. As highlighted in the previous point, if the healing of any minor cut/injury is beyond 2 days and you observe the discoloration even if its not painful, visit your doctor and get yourself checked.
  • Your feet or legs often feel cold, even if the rest of you is warm. It is a very generic sign and do not be alarmed though keep a watch.

• • Blackened toes – If you observe discoloration of your toes (foot fingers/nails), immediately get it treated.

• • You feel pain or cramping in your calves or thighs when you walk, but it gets better when you rest.

• • You can’t easily feel a pulse in your feet.

3. Infection

People with diabetes have a weakened immune system, which makes it harder for their bodies to fight off germs and heal even tiny cuts or blisters.

What might seem like a harmless scrape can turn into a serious infection in just a few days.

If these infections are not treated right away, they can spread deeper into the tissue, reaching muscle or even bone. This can lead to conditions like cellulitis, abscesses, or the dreaded gangrene—where tissue dies due to lack of blood supply and infection.

Some signs to watch for include

• • redness, swelling, warmth around the wound,
  • pus or drainage,
  • foul odor, and/or
  • fever

Diabetic foot infections are one of the most common reasons for hospitalization in people with diabetes, and they can become limb- or even life-threatening if ignored.

Peripheral angioplasty, also known as endovascular revascularization, is a very effective, minimally invasive procedure designed to restore proper blood flow through narrowed or blocked arteries in the legs—especially in patients with diabetic foot complications.

This procedure is a critical tool in the fight against limb loss, dramatically improving wound healing and reducing the risk of major amputation.

How Peripheral Angioplasty Works:

• Performed by Expert Interventional Radiologists: The procedure takes place in a specialized catheterization laboratory (Cath lab) under the care of a highly trained interventional radiologist.
• Minimally Invasive Access: A small incision—often in the groin or arm—allows the doctor to insert a thin, flexible catheter into the blood vessels without the need for large surgical wounds or general anesthesia.
• Precision Navigation using Advanced Imaging: Real-time imaging techniques such as fluoroscopy guide the catheter directly to the site of arterial blockage, ensuring pinpoint accuracy and safety.
• Balloon Angioplasty and Stent Placement: A specialized balloon is attached to the catheter & is inflated to widen the artery. If required, a stent (a tiny mesh tube) is inserted to keep the artery open and maintain healthy blood flow.
• Immediate Restoration of Circulation: By reopening blocked arteries, angioplasty rapidly improves blood supply to the foot, accelerating wound healing and preventing dangerous infections from progressing.

Key Advantages of Peripheral Angioplasty for Diabetic Foot:

• No Large Surgical Incisions: The minimally invasive technique means less pain, fewer complications, and a much faster recovery compared to traditional surgery.
• Day-Care Procedure: Most patients experience minimal downtime and can often return home the same day, reducing hospital stays and overall costs.
• Enhanced Ulcer Healing: Improved blood flow enables chronic foot ulcers and wounds to heal more effectively, reducing the risk of serious infection and tissue death.
• Significantly Reduces Amputation Risk: Early intervention with peripheral angioplasty can save limbs and lives by stopping the progression of diabetic foot complications before amputation becomes necessary.
• Customized Treatment for Complex Cases: Advanced techniques, such as drug-coated balloons and atherectomy devices, are available for patients with challenging or recurrent blockages, further increasing the chances of limb salvage.

A. A 2022 meta-analysis in Journal of Vascular and Interventional Radiology reported limb salvage rates over 80% at 1-year post-angioplasty in diabetics with PAD.

B. According to a 2021 review in Diabetes Care, peripheral angioplasty enabled chronic ulcer healing within 12 weeks in more than 60% of diabetic cases, with surgical bypass achieving comparable results only after 16–20 weeks, often with prolonged hospitalization.

Peripheral angioplasty works best early—before irreversible damage occurs. Diabetics should seek immediate evaluation if they notice:

• Wounds or ulcers that do not heal in 2 weeks
• Blackening of toes or skin discoloration
• Burning, tingling, or numbness
• Pain in feet at rest or during walking
• Cold or pale feet

Screening Tools:

• Ankle-Brachial Index (ABI)
• Vascular Ultrasound