PREVENTIVE MEASURES FOR DIABETIC FOOT ULCERS

-By Ibrahim Suleiman PhD

Diabetes mellitus (colloquially known as high blood sugar) is a very common disorder that exerts major public health challenges resulting from severe damage of numerous body organs. Diabetes mellitus affects how your body uses blood sugar (glucose). The Glucose is vital to your health because it’s an important source of energy for the cells that make up your brain, muscles and all other tissues in your body.

The prevalence of the disease is dramatically increasing at an alarming rate. According to the International Diabetes Federation (IDF), there are currently about 463 million persons living with diabetes in the world. Varying reports have placed the prevalence of diabetes in Nigeria at around 2 to 12 % of the population (about 4 to 21 million people).

Irrespective of the type of diabetes you may be suffering from, the disease commonly present with symptoms such as increased thirst, frequent urination, extreme hunger, weight loss, fatigue, blurred vision, slow-healing sores and frequent infections (such as gums, skin and vaginal infections).

Health complications may occur in poorly controlled diabetes, these may include heart disease (or stroke), kidney damage, eye damage (blindness, cataract and glaucoma), skin infections, hearing impairment, dementia (e.g. Alzheimer’s disease), depression, nerve and foot damage.

Nerve damage results from excess blood sugar which injures the walls of the tiny blood vessels (capillaries) that nourishes your nerves, especially in your legs. This can cause tingling, numbness, pain that usually begins at the tips of the toes or fingers and gradually spreads upward. If left untreated, this may lead to loss of all sense of feeling in the affected limbs and erectile dysfunction in Men. Nerve damage in the foot increases the risk of various foot complications (otherwise termed diabetic foot syndrome) such as foot ulcers, cuts, blisters and infections that may ultimately require toe, foot or leg amputation.

Foot ulcers are most common under your big toes and the balls of your feet. About 15% of diabetic patients in Nigerian develop foot ulcers. This complication if not properly controlled, may result in amputation of the affected foot. Therefore, it is pertinent for you to understand how to prevent foot ulceration by adhering to good foot hygiene methods.

Signs of foot ulcers are not always obvious. Sometimes, you won’t even show symptoms of ulcers until it has become infected.

However, early signs of foot ulcer include unusual toe swelling, irritation, redness, foot odours and drainage from your foot that might stain your socks or leak out in your shoe. Sometimes you may develop a noticeable lump that isn’t always painful.

Some risk factors that may lead to foot ulcers include poorly fitted or poor quality shoes, poor hygiene (not washing regularly or thoroughly), improper trimming of toenails, alcohol consumption, eye disease from diabetes, heart disease, kidney disease, obesity, tobacco use (because it affects blood circulation) and old age.

One major way of preventing early-stage foot ulcer complication is to stay off your feet to reduce pain and prevent further ulceration. This is commonly called off-loading, and it’s helpful for all forms of diabetic foot ulcers. Pressure from walking can worsen foot infection and expand the ulcer. For people who are overweight or obese, extra pressure may be the cause of ongoing foot pain.

Other recommendations may include the use of diabetic shoes, casts, foot braces, compression wraps, use of shoe inserts to prevent corns and calluses. Footbaths, disinfecting the skin around an ulcer and keeping the ulcer dry with frequent dressing changes are some of the criteria useful in inhibiting bacterial growth and further infection.

Your doctor may recommend that you seek surgical help for your ulcers and may prescribe drugs such as antibiotics, antiplatelets, or anti-clotting medications to treat your ulcer if the infection progresses even after preventive or anti-pressure treatments. Also, the use of home-made therapies such as honey, grape seed extract, aloe vera gel, ginkgo Biloba and calendula crème has been very helpful in many patients.

Records have shown that diabetic foot ulcer is the highest cause of non-traumatic amputation. Preventive care is very crucial. Closely manage your blood glucose, as your chances of diabetes complications remain low when your blood sugar is stable. You can also help prevent diabetic foot problems by washing your feet daily, avoid walking barefooted, keep your toenails adequately trimmed (but not too short), keeping your feet dry and moisturized, change your socks frequently, eat nutritious diet, see a Doctor for corn and callus removal and wear proper-fitting shoes.