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Top 15 Facts on Diabetic Foot

What is Diabetes?

Diabetes is the most rapidly progressing, non-communicable disease of the 21st century. Diabetes affects 422 million people worldwide, with a dramatic increase in developing countries. In India, about 6 percent of the population suffers from diabetes. By 2025, it is estimated that every fifth diabetic in the world will be an Indian (1 Trusted Source
Diabetes

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).

Diabetes is also known as the Iceberg Disease or Silent Disease as the clinical presentation is only a fraction compared to the totality of the disease. It is associated with variable clinical manifestations and many complications. Diabetic foot is one such serious problem. The term diabetic foot comprises a group of ailments ranging from neurological and blood circulatory problems to complications arising from injuries or infections (2 Trusted Source
The tip of the iceberg: an overview of diabetic foot disease

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).

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Facts on Diabetic Foot

Statistics on Diabetic Foot

  1. According to a clinical survey, diabetic foot accounts for 16.2% of all diabetic hospital discharges. Also, the average hospital stay is around 13-14 days (3 Trusted Source
    Clinical profile and outcome of diabetic foot ulcer, a view from tertiary care hospital in Semarang, Indonesia

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    ).
  2. Foot problems account for up to 15% of healthcare costs and 40% of the total available resources in developed countries. Through early identification, diagnosis, early intervention, and patient education, the costs can be reduced (4 Trusted Source
    Literature review on the management of diabetic foot ulcer

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    ).
  3. About 60-70 percent of people with diabetes have mild to severe forms of nerve damage. People with long-standing or poorly controlled diabetes are at risk of having damage to the nerves in their feet. It is also called peripheral neuropathy (5 Trusted Source
    Diabetic Neuropathies: The Nerve Damage of Diabetes

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    ).
  4. About 15-25% of people with diabetes have foot ulcerations. In fact, a non-healing or slow-healing ulcer is the first indication of diabetes. It is estimated that one in every six people with diabetes will have a foot ulcer during their lifetime (6 Trusted Source
    Diabetic Foot Ulcer

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    ).
  5. Up to 70% of all leg amputations happen to people with diabetes. In fact, people with diabetes are 25 times more likely to lose a leg than people without the condition. Uncontrolled diabetes, especially in the elderly, is the leading cause of leg loss. Statistics indicate that every 30 seconds a leg is lost to diabetes. About 80-85% of diabetes-related lower extremity amputations are preceded by a foot ulcer (7 Trusted Source
    Amputation in Diabetic Patients

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    ).
  6. Up to 85% of all amputations due to diabetic foot can be prevented. After an amputation, if the blood sugar is not effectively controlled, the chance of another amputation within 5 years is as high as 50 % (8 Trusted Source
    What is the most effective way to reduce incidence of amputation in the diabetic foot?

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    ).
  7. Comprehensive foot care programs can reduce amputation rates by 45% to 85%, according to the National Diabetes Education Program (NDEP). This is a partnership among premium institutes (9 Trusted Source
    Diabetes Foot Self-care Education Effects on Diabetic Foot Ulcers and Amputations

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    ).
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Risk Factors of Diabetic Foot

  1. Damage to large blood vessels (Macro Vascular Disease) leads to poor blood circulation in diabetics. This occurs due to the hardening of the walls of the arteries (atherosclerosis). This is more likely to affect the extremities of the body, especially the feet. When blood flow to injured tissues is poor, healing does not occur properly (10 Trusted Source
    Vascular complications of diabetes: mechanisms of injury and protective factors

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    ).
  2. Damage to small blood vessels such as capillaries (Micro Vascular Disease). Thickening of the capillary walls coupled with elevated blood glucose level reduces blood circulation to the feet. Extreme cases may progress to gangrene (11 Trusted Source
    Diabetes-Related Microvascular and Macrovascular Diseases in the Physical Therapy Setting

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    ).
  3. Higher risk of Infections.  These include bacterial skin infections (cellulitis), bone infections (osteomyelitis), and Athlete’s foot [a fungal infection]. Minor cuts or injuries can lead to serious infections and should be treated promptly (12 Trusted Source
    Bacterial skin and soft tissue infections in adults: A review of their epidemiology, pathogenesis, diagnosis, treatment and site of care

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    ).
  4. Diabetics are at high risk of developing gangrene (dead tissue) in the feet. This is due to the degenerative changes like atherosclerosis or thrombosis (a clot in a blood vessel) associated with chronic diabetes. In such cases, the blood flow is completely cut off, resulting in necrosis or tissue death (13 Trusted Source
    Gangrene

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    ).
  5. Charcot Arthropathy is a rare complication of diabetes. It causes weakening of the bones resulting in fractures, dislocations and severe deformities. In most cases, charcot foot occurs after the age of 50 (14 Trusted Source
    Charcot Neuropathic Osteoarthropathy

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    ).
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Causes of Diabetic Foot

  1. Smoking accelerates damage to the small blood vessels in the feet and legs. This damage coupled with high glucose levels can disrupt the healing process and increase the chances of infections and amputations (15 Trusted Source
    Review of the role of cigarette smoking in diabetic foot

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    ).
  2. Poorly fitting shoes are a common cause of diabetic foot problems. They cause common problems like blisters, corns, calluses, which if neglected can lead to serious medical conditions (16 Trusted Source
    Corns and Calluses

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    ).

Prevention of Diabetic Foot

  1. It is advised to wear proper and comfortable footwear. Shoes with broad square toes along with seamless socks are considered best. Narrow tipped shoes and high heels are to be avoided.

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Last Updated on Oct 19, 2023
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