A large number of diabetic patients suffer from some form of foot ulcers at some point of time. When neglected, these progress to dire consequences. Over time diabetes damages the nerves, giving rise to a condition called peripheral neuropathy. It diminishes the ability of a person to sense the pain or sores, making small injuries go unnoticed, aggravating it. Diabetes can also result in the clogging of many peripheral arteries, which reduces the blood supply to the legs, making feet prone to infection and gangrene. Poor control of diabetes makes the connective tissue fragile and damages the complicated foot architecture.
Top tips to care for the diabetic foot:
- Reduce the pressure on the affected leg and keep the foot elevated.
- Take care of continuous maintenance of sterile, non- adhered dressing. If wet or blood-soaked, it must be changed immediately.
- If reduced blood supply is the cause of foot ulcer, an intervention or surgery may be considered to improve the circulation. A very good control of your diabetes is the key point. The target of treatment is to prevent blood sugar fluctuations as much as possible. Ask your doctor about your ideal sugar level and work out to maintain it as much as possible.
- Never dip your feet in hot water – it may be dangerous. Always use lukewarm water. Clean the web spaces as well. Mop your feet dry including the web spaces.
- For dry and scaly skin, apply moisturizing lotion or cream and put on cotton socks while retiring to bed at night. Do not leave extra lotion in the web space as it may macerate the skin.
- Always use socks – the thicker, the better.
- Strictly abstain from consuming tobacco in any form.
- Take time to inspect your feet. Look for cracks, calluses, disfigured nails. Look in the web spaces space in between two fingers. Use a mirror to inspect the soles. If possible, have someone inspect them for you.
- Walking barefoot is not a very good idea for diabetics as it makes feet more vulnerable to injury and makes an easy entry site for germs.
- Always use comfortable footwear. An ideal shoe should be comfortably and snugly fit and must not put pressure on the toes. Change your shoes at regular intervals and avoid using damaged or tattered footwear. Tennis shoes and suede shoes are least likely to create foot problems.
- Avoid web-strap shoes (like hawai chappal). Your walking shoe should have a wide and roomy toe box and there should be sufficient shock absorbers in the soles.
- Depending upon the condition, you will be prescribed antimicrobial agents. An infected ulcer needs aggressive treatment to prevent spreading. If ulcer is wide-spread or deep, it may need a small procedure called debridement, where the infected portion is removed. It is usually an outpatient procedure done under local anesthesia.
Never ignore any of the symptoms and check with your doctor. Treatment of foot ulcer is multidisciplinary and multi-pronged. Along with your diabetologist, you may need the expertise of a podiatrist, neurologist, dermatologist, vascular surgeon, cosmetic surgeon, depending upon the extent of the ulcer.
Things to watch out for:
- Altered sensation in your foot
- Burning sensation
- Walking impairment, like cramping
- Feet suddenly turning cold without joint swelling
- Edema or swelling of feet
- Excess fatigue
- Pain in leg even in rest
- Any open wound, cuts, bruise or unusual marks
- Any change in skin colour or texture of feet
- Any change in nail area
- Sensation of vibration or tingling
Busting Sugar-free Myths
We all might not need artificial sweeteners, but we all have definitely heard about it and even used it perhaps on more than one occasion. With so many new brands foraying into the business, Saccharine is not alone in the market any more as a substitute for sugar.
Artificial sweeteners promise the same sweet taste minus the calories. So diabetic patients or anyone who wants to cut down on sugar can still have sweets, syrups, desserts without worrying about the calories.
But are artificial sweeteners safe?
- There are mainly four artificial sweeteners in the market – Sucralose, Saccharin, Cyclamate and Acesulfame potassium which has often been linked to various forms of genetic abnormalities and cancer.
- Artificial sweeteners cause bloating and other gastric problems.
- Saccharine was not considered as a safe alternative till a few decades ago. Various tests proved that consumption of saccharine contributes to increased risk of urinary bladder cancer.
- Also, artificial sweeteners are very new in the market to point out any side-effects in the long run.
The safety regarding the consumption of artificial sweeteners is always debatable, be it on papers, in courts, in labs or in the market.
It is always advisable to avoid artificial sugar. Taking a small amount of honey or natural sugar, or cutting sugar off completely , rather than consuming more amount of artificial sugar is always a healthy option.