Diabetic Foot Treatment in Mumbai

Diabetes is a chronic medical condition which refers to inability of human body to process blood glucose/sugar optimally. Diabetes is considered as the most prevalent medical condition globally with India being considered the diabetic capital of the world.
Diabetes management depends on the type of diabetes and it is to be noted that diabetes not necessarily results from being overweight or an inactive lifestyle. In fact, diabetes could develop childhood and the probability of developing diabetes increase significantly if any of the parents had diabetes.

While diabetes does affect the quality of life by itself, the medical condition is considered serious die to various ailments it can contribute development of. For example, diabetes has been proven to cause damage to eyes, kidneys, nerves, heart etc. Diabetes is also known to severely effect healing process of the body.

How Does Diabetes affect our feet?

Patients with diabetes are prone to develop foot problems dues to extended periods of unhealthy blood sugar levels. Peripheral Vascular Disease & Diabetic neuropathy are two alarming conditions which develop mostly due to diabetes and can severely impact your foot.
While awareness about such feet problems due to diabetes is less, it should be noted that more than 50% of amputations (severing of limbs) globally are done due to diabetes related medical conditions.

Peripheral Vascular Disease:
Diabetes causes changes in blood vessels including arteries by formation of fatty deposits in the blood vessels. It is observed to mainly effect the blood vessels to and from the extremities like foot and hand. Formation of these obstructive deposits in such blood vessels leads to reduction in flow of blood to such body areas resulting in pain and in more serious cases infection and very slow healing of any wounds or injury in such body parts.
Slow healing of any injury or wounds significantly increases the probability of development of lethal infection like gangrene mostly resulting in amputation of the limb if not timely treated.

Click Peripheral Vascular Disease to know more.

Diabetic Neuropathy:
Prolonged diabetes cause nerve damage which many times result in numbness/lost of sensation in feet. Due to this condition a person finds it difficult to feel any irritation, injury, pain or infection in the limb. For example, a person may not realise that the footwear is not fitting properly. Such loss of sensation increases risk of unattended injuries, blisters or wounds. Diabetes further slows the auto healing process of the body resulting in development of infection/ulcers in the injuries/wounds.

If you have diabetes and you experience any of the symptoms as explained in the next section, do get yourself evaluated for probability of development of diabetic foot by specialist doctors as again explained in the article ahead.

Symptoms indicating you may have diabetes related foot problems

In addition to Diabetes, if you experience any of the following symptoms in your limbs you should get yourself evaluated for diabetic foot. Note that the symptoms differ from person to person and depends on specific issues patient is having.

  •  Loss of sensation
  • Periodic or Permanent Tingling Sensation or Numbness
  • Temperature changes in the limbs (development of hot spots which are tender to touch)
  • Wounds or Blisters (with or without pain)
  • Frequent development of slow/non healing wounds/ulcers/blisters on the foot
  • Discolouration of skin or red streaks.

Note that discovery of non-healing Ulcers/ Wounds is the most common stage where diabetic foot is diagnosed globally as other symptoms being generic are often overlooked by patients and non-specialist medical professionals.

Diagnosis & Treatment of Diabetic Foot

If you have diabetes, the best practice would be to have your diabetologist check your feet during your regular consultations to enable early identification of onset of diabetic foot issues. Please note that unless you have the symptoms identified above, the evaluation will be inexpensive as it is mostly physical assessment of the limb.
However, if you are experiencing any of the symptoms given above or any other issues with your foot along with diabetes you may have to undergo some tests to confirm the condition and identify proper treatment plan.

Treatment

Understanding treatment of diabetic foot ulcers requires basic understanding of healing process which our body naturally adopts.
We all know that our injuries/wounds/ulcers automatically heal if there is no other condition which is affecting the natural healing process. With diabetic foot, diabetes reduces continuous flow of oxygenated blood to the ulcer / wound site which is essential for the natural healing process. Hence, flow of blood at the ulcer needs to be checked for adopting a treatment plan.
A Comprehensive Treatment of Diabetic Foot Ulcers requires a team of specialist doctors as explained in the following treatment options. The treatment team mostly consists of your diabetologists (Endocrine/physician) who is managing your diabetes and an interventional radiologist who is required if the blood flow to the ulcer/wound is required to be corrected.

Transcutaneous Oxygen Pressure Test (TcP02)

TcP02 is a test which is very important to measure flow of oxygenated blood to the affected tissues. It is an inexpensive test which measures the oxygen uptake and transport capacity of the blood and general status of the circulatory system inside the human body. Any obstruction in ability to deliver oxygen to the tissue is immediately disclosed with this test and thus is very helpful in determining the optimal treatment plan.
TcPO2 is a very inexpensive test which is done on outpatient basis. It is a non-invasive test and hence there is no pre-post care required. A patient should insist on such test before undergoing treatment for the diabetic foot ulcers.

Non-Surgical Treatment Option

If the readings revealed under TcPO2 are satisfactory and confirmed by doctor’s physical exam, patient is given out-patient care i.e.
- Cleaning of the Wound
- Debridement of the dead tissue
- Dressing of the wound
Patient is under regular observation of the treating doctor to identify any spread of infection.

Surgical treatment Option

In most cases, diabetic foot is diagnosed at later stages wherein TcPO2 reveals impairment if oxygenated blood flow. At this point, an additional specialist doctor, an interventional radiologist is introduced in the treatment plan by your primary diabetologist/endocrine/physician.
An interventional radiologist provides service under the treatment plan governed by your primary doctor.

  • Surgical Treatment – Peripheral Angioplasty (No Amputation)
    In case where the patient is identified for surgical treatment and the infection is in control, an interventional radiologist performs a minimally invasive peripheral angioplasty to correct the blood flow to the affected tissue in the limb.
    It is normally preferred over surgery due to it being less invasive and gives faster recovery to the patient. There are various kinds of Angioplasty performed depending on the condition of the patient:

    • Balloon Angioplasty
    • Atherectomy
    • Laser Angioplasty
    • Stenting
  • Amputation

In some cases, patients are identified at later stages wherein not much choice is available but to amputate the limb to stop infection from spreading further. While this may affect quality of life it is required to save life of the patient.

Peripheral Angioplasty has proven to be the most successful treatment methodology for diabetic foot. A patient should always ask the treating doctor if an additional opinion from interventional radiologist will be helpful.
If you are evaluating various options of treatment, you can connect with us to get proper guidance and free online medical opinion.

Post-Operative Care

As common aspect of all the treatment options, patient needs to be on medication to control the infection and management of wound site i.e. cleaning, dressing is to be done on periodic basis under the direct supervision of the primary treating doctor.
Also, patients may be recommended to wear special footwear depending on the site of ulcer to avoid contamination and support healing.

Diabetic foot care
Recurrence of Diabetic foot ulcers is a possibility depending mainly on diabetes management. A patient should follow the below mentioned steps to limit the recurrence of the issue

  • Regular follow-up examination of the feet is important to prevent development and recurrence of issues like infections.
  • Controlled blood sugar is key to health for patients of diabetic foot.
  • Blood flow to the tissues is adversely affected with smoking, which can make foot problems worse in people with diabetes.
  • Self-Check the feet regularly: Self examine the feet regularly daily to discover early any injuries/ulcers.
  • Keep Feet Clean: It is important to clean your feet to avoid occurrence of any infection.
  • Right footwear can help avoid development of any blisters or ulcers in feet. At the same time very tight footwear and socks should be avoided.
  • Putting the feet up while sitting and periodic wiggling of toes promote blood flow to the feet.
  • Treatment of bunions and corns should be done very carefully as the chances of development of infection is very high.
  • If you are evaluating various options of treatment, you can connect with us to get proper guidance and free online medical opinion.

If you are evaluating various options of treatment, you can connect with us to get proper guidance and free online medical opinion.

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