Diabetes and Foot Care

Diabetes and Foot Care

Peripheral Vascular Disease (PVD) in Diabetics affects infra-inguinal arteries more than the aorto-iliac system. Even though claudication is the commonest symptom of PVD, a diabetic is more likely to present with tissue loss without any previous symptoms Diabetic PVD is a more aggressive disease. Rapid progression of 'early' critical limb ischemia (CLI) to gangrene occurs in 40% of the diabetics as opposed to 9% in non diabetics. Sudden progression from intermittent claudication to limb threatening ischemia occurs in 35% of diabetics (19% in non-DM) with 21% risk of major amputation. A thorough evaluation of the diabetic foot is done at the center to decide on the modality of treatment. Management involves Total Contact Casting Regular debridement, with dressings Drugs to control infection Vascular reconstruction if required Elective surgeries to correct structural deformities At the center the Foot care specialist, Interventional Radiologist and Vascular surgeons work in unison, so as to perform foot sparing reconstructive procedures at the right time and thus prevent unnecessary amputation.