Treatment of Diabetic Foot

Diabetes is one of the biggest curses of modern lifestyles. It leads to several complications, and one of the most frustrating complications has to be foot ulcers. Foot ulcers are a significant component of what is called Diabetic Food Syndrome. These ulcers form when skin tissues break down and reveal the layers underneath. It is critical to get treatment of diabetic foot in time.

Unlike some other complications from diabetes, these are, unfortunately, not treatable with usual health care methods like diet or excise – even an insulin treatment won’t work against them. A proper treatment of diabetic foot is required. Diabetic foot ulcer treatment should only be taken from the very physician you will find.

Where do ulcers occur?

The ulcers most commonly occur under patients’ biggest toes and balls of their feet. Their effect can run deep – to the level of bones. In the worst cases, they may lead to amputation. Though almost everyone with diabetes can get this condition, good foot care can go a long way in preventing it. If you have ulcers, we highly recommend seeing your doctor about them.

According to recent research, more than half of diabetic foot ulcers tend to become infected. About one in every five, moderate to severe foot infections in people with diabetes will lead to amputation.  Thus, getting timely diabetic foot ulcer treatment is of utmost importance.

Common Symptoms

One of the first symptoms of diabetic feet is the same sort of drainage from the feet – that might show up as strains in socks or even leak out of shoes. Some other early symptoms involve unusual foot swelling, irritation, and redness. The odour coming from feet may be another common symptom of Diabetic feet, and pain and numbness in the foot is another common symptom.

Apart from that, there are visible sights too – involving eschar. A black tissue surrounding the ulcer will result from and signifying a lack of healthy blood flow to the area of the foot where an ulcer is formed. If you notice any skin discoloration in your foot whatsoever, you should make a point of getting it checked by a doctor.

Another visible sign is lumps that sometimes form with ulcers.

Partial or complete gangrene is another common symptom. Gangrene is the death of tissue death due to infections, and it often appears around the diabetic foot ulcer.

Here you must understand that not all these symptoms will appear at once. It is vital to act with caution on this score and get yourself checked, even if there is only the slightest sign of any of the above symptoms. The earlier it gets diagnosed, the better the chances of diagnosis will be.

Diagnosis of Diabetic Foot

As regards diagnosis, your healthcare provider will diagnose whether you have a diabetic foot or not. If the answer is an unfortunate affirmative, they will help you identify this ulcer’s seriousness using a scale of 0 to 5. This scale is called Wagner Ulcer Classification System. Let us briefly discuss what various levels of this scaling system signify:

Scale 0

You have no open lesions and may have healed lesions, and there may be very little or no reason to worry.

Scale 3

At this level, even deeper tissues get involved, including abscess, tendonitis, or osteomyelitis.

Scale 1

There is only a superficial ulcer without penetration to deeper layers.

Scale 4

There is gangrene in at least a portion of the foot or heel.

 

Scale 2

The ulcer is not external but is more profound and reaches tendon, bones, or joint capsules. The healthcare provider may order an X-ray if the doctor has suspected that the ulcer of infection has gone through the bones.

Scale 5

This is the worst level and signifies an extensive gangrenous involvement in the entire foot

As you can see, the levels grow progressively worse. And it can often be the case with diabetic feet. That is why it is crucial to get the proper treatment for this problem – and to get yourself checked even if there is only a very slight sign of any of the symptoms. 

What Causes Diabetic Foot Ulcers?

People with diabetes are far more susceptible of foot ulcers because of the following causes:

  •     Hyperglycaemia

Hyperglycaemia refers to the presence of high blood sugar or glucose levels. One problem with high blood sugar is that it can slow the healing of infected foot ulcers. Thus, people with type 2 diabetes have more difficulty fighting off infections from ulcers.

  •     Poor blood circulation

One of the most common vascular diseases is poor blood circulation due to the high amount of sugars in the blood – and it is a common cause of foot ulcers in people with diabetes. Simply put, people with diabetes have poor blood circulation, and as a result, far lesser blood reaches the feet. The lack of proper blood circulation can lead to the formation of ulcers.

  •     Nerve damage

One of the long-term effects caused by high blood sugar is that it causes damage to nerves. Damaged nerves can make one feel tingly and painful in the beginning.

On the other hand, when the nerve damage is complete, it reduces or total loss of any sensitivity in the feet to pain. The result is painless wounds that may remain ignored or take the shape of ulcers.

  •     Irritated or wounded feet

The irritation and wounds can often lead to ulcers in the feet.

The Critical Risk Factors For Diabetic Foot Ulcers

As mentioned earlier, everyone with diabetes is also at risk of foot ulcers. The ulcers may have several causes, and several factors lead to an increased risk for the disease, including the following:

  • Wrong kind of shoes that fit poorly.
  • Shoes made of poor-quality material.
  • Poor foot hygiene habits such as not washing feet often enough or not drying them after washing.
  • Ignoring the trimming of or improper trimming of toenails.
  • Excessive alcohol consumption having high-calorie content contributes to diabetes.
  • Eye diseases from diabetes may also signify increased chances of getting ulcers.
  • Heart disease can affect blood flow.
  • Kidney disease as it affects blood flow.
  • Obesity as it magnifies the effects of diabetes.
  • Tobacco use as it inhibits blood circulation.
  • Diabetic foot ulcers are also most common in older men.

Please note that combating and reducing these risk factors can also help prevent the formation of these ulcers – this is discussed in detail later.

Treatment Of Diabetic Foot Ulcers

The treatment of diabetic foot ulcers involves a multi-faceted approach. Some of the most important ways of tackling the problem are the following:

  •     Avoid using affected feet

First, if you have a diabetic foot, you may want to avoid standing or walking – stay off your feet to prevent pain. It is not about pain; putting unnecessary pressure or stress can worsen the infection, and the ulcer may expand.

  •     Custom footwear options

There are several treatment options that your healthcare provider may recommend. It may include certain wearable items such as:

Ø Custom shoes specifically designed for people with diabetes. They are a crucial part of diabetic foot ulcer care.

Ø Casts intended for the purpose

Ø Foot braces for people with diabetes

Ø Compression wraps made explicitly for the purpose

Ø Shoe inserts that provide further protection to feet against corns and calluses

  •     Ointment

Your healthcare provider may prescribe the best ointment for diabetic foot ulcer after carefully analysing your foot. This ointment should be applied as instructed by the healthcare provider. It is easy to find an excellent diabetic foot ulcer treatment ointment in Mumbai and other major cities of India. Finding the right kind of diabetic foot ulcer treatment ointment in Mumbai is important to ensure effective treatment. Good news is that you can easily find the best ointment for diabetic foot ulcer in India. We shall return to this subject later.

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  •     Debridement

Debridement is a crucial tactic for diabetic foot ulcer care. It refers to removing any dead skin or foreign objects that may have caused the ulcer. A healthcare provider may do this to remove the cause of the issue and initiate or fasten the healing process.

  •     Measure to prevent infection

In case you currently have a foot ulcer, the following are some of the essential measures to prevent its infection and are also an important part of diabetic foot ulcer care:

Ø Regular foot baths

Ø Disinfecting the skin around an ulcer

Ø Keep the ulcer dry

Ø Frequent dressing changes

Ø Enzyme treatments

Ø Dressings containing calcium alginates. They will prevent the growth of harmful bacteria.

Ø Medication

The healthcare provider may prescribe antibiotics, anticlotting medications, or antiplatelets to help treat the ulcers if the infection progresses, even after preventive or anti-pressure treatments mentioned above.

  •     Treatment of infections with antibiotics

An infection of the feet is a rather severe complication of foot ulcers and requires immediate treatment. Not all infections are treated the same way, and one must determine which antibiotic will work best to treat the inflection with an antibiotic. 

Please note that many of these antibiotics may attack Staphylococcus aureus, and it is a bacteria known to cause staph infections. They may also attack ß-haemolytic Streptococcus – a bacteria typically found in human intestines. Thus, your healthcare provider must be well aware of your other health conditions, especially those that may increase the risk of you getting infected by these harmful bacteria, including HIV and any liver problems.

  •     Surgical procedures

In the worst of cases, a surgical procedure may become imperative as the diabetic foot ulcer treatment. The surgery can help alleviate the pain caused by pressure around the ulcer by shaving down the bone and removing foot abnormalities like bunions and hammertoes. Some surgeries may need to replace the skin with synthetic substitutes. Surgery may be necessary to amputate the leg in the most unfortunate cases.

You must note that surgeries are not needed in most cases of diabetic foot ulcers, and it is only an option left as a last resort.

  • Improving blood circulation to the foot or affected area with ulcer or wound

It is essential to consult an expert Interventional Radiologist when getting to determine your ulcer treatment plan. You should make a point of getting the best diabetic foot ulcer treatment doctor in Mumbai. The interventional Radiologist may give medicines or plan an angioplasty to improve the circulation to the affected area in the foot. Along with that, wound care, off loading the feet will be suggested simultaneously.

About Dr Gaurav Gangwani

Dr Gaurav Gangwani had 10+ years of experience. Build valuable relationships with patients

I am an Interventional Radiologist. My speciality is a unique one where I offer minimally invasive interventions which can treat complex medical conditions without the need for surgery.

With a rich academic and research experience, I am hoping to add the same services for a variety of interventions in Mumbai now. My strength is understanding the patient mindset and being transparent with the counselling explaining everything.

So that the patients are empowered with the knowledge to choose or reject treatment decisions wisely.

Preventing Ulcers, Infections, And Other Foot Problems

The adage ‘prevention is better than cure is especially true for foot ulcers. One can do several things to prevent ulcers, infections, and other foot problems. Some of these measures include the following:

  •     Manage The Blood Sugar Levels

Naturally, it is crucial to fight the problem at its source. And with ulcers, the root of the problem is diabetes. Thus, it is important to monitor and manage one’s blood glucose levels to keep the chances of various glucose complications low. You should make a balanced diet chart in consultation with your healthcare provider and stick to it. It is also essential to stick with a good exercise routine.

Ø Wash your feet properly every day. Unclean feet are far more prone to ulcers and other foot problems.

Ø Always keep your toenails adequately trimmed but not excessively short. Untrimmed toenails can gather dirt and provide breeding grounds for germs.

Ø Keep your feet dry and their skin moisturized. Feet kept wet for too long are more suspectable to foot problems. Lack of moisture may cause dead skin cells.

Ø Change socks daily or as soon as they get wet – whichever is earlier. Wet socks or shoes can be like an invitation to infection.

Ø Always see a healthcare provider for corn and callus removal.

Ø Wear proper-fitting shoes made of quality material.

It is also essential to understand that foot ulcers are not a one-time problem, and they can return even after they’ve been treated once. The scar tissue in question can become infected if the area is aggravated again. Thus, your healthcare provider may recommend special preventive measures, such as wearing shoes specially made for the purpose.

When To See Your Doctor

It is better to err on the side of caution. So, if you notice any numbers, blackened flesh, or skin discoloration, you should seek a consultation with a doctor right away. It should be the case even if you don’t have diabetes. If you do have diabetes, then this is even more crucial. It is essential to understand that ulcers can do much more damage than may appear at first sight – in several cases, surgeries become compulsory, and there may be a need to replace lost skin with synthetic skin substitutes or amputation.

4 Essential Things to Follow

Foot ulcers are a serious medical condition – that often doesn’t get taken as seriously as they should. And that is unfortunate because if it gets caught early, it can easily be treated with far lesser damage. Four things to take care of:

  • Firstly, one should always take proper care of one’s feet hygienically, whether or not one has diabetes or diabetic feet.
  • Secondly, if there are ulcers, one should see a healthcare provider about them quickly and start the treatment swiftly prescribed.  
  • Thirdly, whether or not one has diabetes or diabetic feet, though especially if one does, one should take measures to keep the blood sugar.
  • Fourthly, it would help if you took all measures to ensure that ulcers won’t lead to infection. That is doubly important in cases where people may be especially at risk of such infections.

In most cases, you can prevent the dire health consequences of diabetic foot ulcers as long as the ulcers are caught in time. 

Feet are a more critical part of human anatomy than they usually get credit for, and many people don’t pay enough attention or care enough for them. Primary measures for foot hygiene can go a long way in avoiding many tragedies such as amputation. If you have been ignoring your feet till now, you should start doing that now – especially if you have diabetes.

Dr. Gangwani is the best place to get diabetic foot ulcer treatment ointment in Mumbai. We also provide some other treatments such as non surgical fibroid treatment and also avail medicine such as gangrene medicine.

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