Diabetes is one of the most common diseases in the world and a leading cause of below-knee amputations. It is estimated that every thirty seconds someone around the world loses a leg to diabetes.

Pain and other sensations of our body act like an alarm to indicate any undue pressure or injury that the body is subjected to so we can take measures to treat it in time. This mechanism is impaired in diabetes as increased glucose levels in the body cause damage to the nerves, thereby reducing the body’s sensitivity to pain, temperature and vibration. Hence, the extremities become vulnerable to trauma allowing infections to fester.

It is popularly advised that diabetics take care of their feet like they would of their face. Diabetic patients need to closely examine their feet every night, ideally with the aid of a mirror so as to spot any impending foot injury in the hard-to-see areas such as the soles and the areas between the toes.

Some important clues to imminent foot injury may be a change in the colour of the skin/nails, shape of nails, skin texture, dryness, decreased temperature (if the foot or the toes feel cooler than the rest of the body), loss of hair, hardness, any breach/cracking or white patches, particularly between the toes. Any unusual change/injury calls for a quick visit to a chiropodist, in addition to comprehensive annual foot screening. Neglecting simple foot problems and failing to visit a doctor can be detrimental to health.

Minor cuts while trimming nails or minor burns while taking a hot bath may turn into severe injuries for diabetic patients thus they need to exercise immense care and take every precaution. This is especially important while choosing footwear as diabetics often fail to notice footwear that is tight or causing foot sores.

Diabetics are recommended to buy shoes in the later part of the day when the feet are slightly swollen and buy the size that feels comfortable on the larger of the two feet. Measure foot size whilst standing, go for leather products as they allow sweat evaporation and wear cotton socks.

Depending on the level of activity, wearing new shoes for even one hour can easily cause a breach in the skin. For that reason brand new shoes should be first tried and worn for short periods at home until they feel comfortable. Laced shoes are better than slip-on types, with rounded toes rather than pointed ones and at least a finger width space between the toes and the end of shoes to maximise comfort. Diabetics should avoid wearing shoes that are tight or uncomfortable even for a short period.

With any complication such as an ulcer, special footwear or shoes with modifications should be used to protect feet from further damage and permit proper healing.

— Komal Motwani