On a Firm Footing

Have you noticed the way babies move? They rock back and forth on their hands and knees when they are about 6 months old. And they move forward, commando-style in an effort to stand. By the time the baby is 11 months old, the baby shuffles around, holding on to furniture. And soon, it is time for great rejoicing, when the baby takes the first step and starts walking.

But by then, an important part of the body has been relegated to the outposts. This part of the body now has to work unseen, unheard and is also, (pun intended) a downtrodden part of the body. Yes, I am talking about our feet, which are the most distant parts of our body, if you accept either the heart or the head to be the "centre" of the human body.

We all talk about looking into our souls and understanding ourselves better. But how many times have we looked under the soles of our own feet? Yet, we are indebted to our soles, which give us a "standing" in life! For people with Diabetes, taking care of the foot is quintessential for a healthy life. Due to the sheer distance of the feet from the heart, blood reaches the foot much later than it reaches the arm. Because of that, any decrease in the blood supply of the feet, as can happen in Diabetes, leads to a diverse set of foot problems. Indeed, Diabetes is the leading cause of foot infections and amputations worldwide.

Good glucose control, weight management, blood pressure control and adequate nutrition can all help in preventing diabetic foot problems. Simply looking at our soles and keeping them clean Gust like we wash our faces) is important to keep the feet safe.

Avoiding barefoot

walking outside and wearing correct footwear can both protect the feet. Look carefully at the web spaces between the toes, and treat the little cracks in the skin there.

These skin cracks are often laden with a whitish hue' signalling a fungal infection. The skin breaks allow bacteria to enter the feet. This is often a precursor to a dangerous foot infection. Hence the importance of preventing and treating the little skin cracks in the feet.

There are two particularly important aspects of preventing foot problems. The first is checking the blood supply to the feet. Your doctor can simply check the pulses of the feet, or when needed, order more advanced check-ups. In general, severe calf pain while walking or running is an important signal of compromised blood supply to the feet. The second aspect of foot assessment pertains to nerve supply.

Nerves are like electrical wires, and they carry sensations from the feet to the brain about injuries, as well as information about the ground on which we walk. When nerves of the feet are damaged, often people develop an uncomfortable sensation of tingling and burning. Later, this is replaced by unsteadiness or sometimes a reduction in sensation (numbness), and that is when foot injuries or even foreign bodies like stepped-upon shrapnel pass undetected. This leads to infection. Diabetes-related nerve damage needs to be diagnosed as early as possible.

Most Diabetes-related foot problems can be predicted, prevented, diagnosed, and treated, thanks to scientific advancements. In this issue of Diabetes Health, we dwell upon the intricacies of foot care. So that as the title says, we can get people with Diabetes "on a firm footing."

Dr Unnikrishnan AG

Editor