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Foot care may save diabetics from amputation

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CHENNAI: Allan Maule, a 47-year-old engineer from Qatar, stumbled twice and almost toppled a mike stand as three persons helped him climb two steps to reach a podium where he was to tell how lucky he was to have escaped amputation.

"I was coming out of the sea barefoot in Goa when I found that the skin had peeled off from under my foot. It became septic, and then it developed into gangrene," said the diabetic who had lost sensation in his feet. He did pedicure, wore custom designed shoes and sandals and beat the need to amputate his legs after he was enrolled for a 10-year study conducted by M V Hospital for Diabetes Royapuram as part of its amputation prevention initiative. "I have regained 50% of my ability to walk. I hope to walk normally in a few days," Allan said.

Doctors at the hospital experimented with a combination of educative measures and foot care to prevent amputation in diabetic patients. Of the 9,570 patients who were studied since the year 2000, only 637 patients needed amputations, while 94% of the patients managed to save themselves from amputation by following simple instructions of the hospital.

Dr Vijay Viswanathan, managing director, M V Hospital for Diabetes, said the 9,570 people selected for the study had lost sensation in their feet or had decreased blood circulation in their legs. "We provided simple foot care management, like daily examination of foot, pedicure and providing them with proper footwear. Constant reminders were sent to the patients to take care of their feet through mails and telephone calls. At the end of the study we found out that it is possible to improve foot care practices among high risk foot diabetic patients and prevent major amputations."

The study proved fruitful as only 6% of the patients studied had to amputate their legs. We have started to make polyurethane foam footwear which is supposed to be the best for diabetic patients because use of normal rubber slippers and barefoot walking are prime reasons that lead to amputation. The study showed that about 24.4% of the patients who had to be amputated used rubber slippers or walked barefoot.

Cricketer Robin Singh who distributed walking aids to diabetic patients said that "chances of getting injured under the feet and toes are high while playing cricket. Players are often on their foot and the legs take the maximum stress."

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