I usually try to keep things light around here. But every once in a while I come across a report so serious that I have to share it with my readers and patients. And the news about diabetic feet, ulcers, amputations and the pandemic is just such an item. Let's take a closer look.
What are Foot Ulcers?
A foot ulcer starts off as a wound. And a wound is any injury that breaks your skin. For most people, these injuries heal quickly. But sometimes they don't. And wounds that don't heal in a timely fashion are considered ulcers. These are chronic non-healing wounds, which may be painful and can limit your mobility.
Chronic wounds are a major health concern for anyone. But they can be especially dangerous for people with diabetes. Because diabetic wounds and ulcers increase your risk for infection. And, ultimately, for amputation. How could that be? If you have a deep, open wound, any infection can travel to your bone. In fact, wound-related bone infections are a leading cause of lower extremity amputations. And that's why you should see me right away for a foot wound. But you should also pay attention to scary statistics about ulcers and the pandemic.
Pre-Pandemic Limb Loss Statistics
A few years back, I found a report from The Canadian Institute for Health Information. At the time, it revealed something I found shocking. What was it? The country saw more than 2,000 foot amputations in 2011-12. And they were due to complications of diabetes.
I mean, those numbers are bad. Canada's population is much smaller than ours. Even worse? In India, 25% of the country's 77 million diabetics are likely to develop ulcers. Plus, Dr. Jan Hux of the Canadian Diabetes Association says “much of that could be prevented." How? He suggested working on better blood sugar control and proper diabetic foot care.
I completely agree. Diabetes increases your risk for ulcers and foot loss because high sugar levels in your blood damages your small blood vessels. And, since they feed the nerves in the feet, you may diabetics lose sensation there (neuropathy.) That makes it harder to tell when you have cuts, blisters or abrasions on your feet. And, when you're unaware, you may not treat a cut or blister. Which means a small infection could progress and expand.
Plus, once diabetic wounds form, they are slow to heal. So, depending on how long a problem goes unnoticed, the damage can progress to the bone, as I mentioned. Which means that some people face amputation for something as simple as an infected blister!
On it's own, that's a pretty scary idea to face. But here's worse news (and I do apologize for being a downer.) The pandemic made things worse for diabetic foot loss.
Rise in Pandemic Related Foot Amputations
Now, I came across new studies in Podiatry Today. And their results were astonoshing. What did they find? Well, since the pandemic, many more diabetic patients were getting amputations.
How many more, are you wondering? Well, one of the studies showed that 18-percent of diabetic patients faced major amputations in 2019. But now? That number rose to 42-percent!
And increasing limb loss wasn't the only pandemic complication for diabetic feet. Because researchers also noticed cases of tissue loss increased by 59-percent compared to last year. Which should be scary for everyone.
Now, these crazy numbers have many contributing factors. First, diabetic patients had higher risks for serious COVID complications. So many people with diabetes delayed or cancelled their preventative care visits during the pandemic.
I understand that instinct. But regular foot checks are crucial to preventing diabetic complications. And, as we can see now, avoiding them could contribute to limb loss. Sadly, that's not the only reason things got worse during this time.
Your Weight, Diabetes and Healthy Feet
As I've said before, being overweight can take a big toll on your feet. Obesity puts tons of pressure on your feet, so you may experience more foot pain. It can also flatten your arches, which can lead to heel pain. But it's really a big problem if you have diabetes.
After all, carrying extra weight makes it harder to control Type II diabetes. Which means you may experience worsening nerve damage. And your blood flow could be further compromised. In combination, these factors increase your risk for ulcers and limb loss.
Now, as we know, COVID shutdowns weren't great for our waistlines. We stayed home a lot more. Which meant we snacked more, and moved less. Plus, most gyms were closed for months to a year. So it's been even harder to drop the pounds we put on during the pandemic.
Weight gain and delayed doctor visits. That's how we got to this post-pandemic jump in limb loss. And we can't change the past. But we can work towards the future, decreasing your risk and protecting your feet.
Diabetic Foot Care to Prevent Limb Loss
Remember, I didn't tell you all this just to scare you. I share because I want you to be aware of the worst case scenario, so that we never reach that point.
To start, I want you to get back into my office for your quarterly visits. (You should come more often if you already have a wound.) But you can't just rely on me to protect your feet. You also have to do the work at home.
Between visits to my Houston podiatry practice, here's what you need to do:
- Check your feet daily. Look for cuts, blisters, redness or pus. (or anything that wasn't there the day before.) Notice a problem? Call us right away and tell the receptionist you have a diabetic foot concern. You'll get an immediate appointment.
- Soak your feet . Daily soaks will help keep your feet clean and infection free. But use lukewarm water, since reduced sensation and hot water could burn your feet. (Test the water with your hand before getting your feet in to be safe.)
- Wash and dry them well – After that soak, take a towel and fully dry your feet, paying extra attention to areas between your toes.
- Moisturize Your Feet. But this time, stay away from the spots between your toes. This will decrease your risk for fungal infections.
- Practice proper nail trimming. Work straight across and carefully file the corners. And, if you even suspect an ingrown toenail, come see me immediately.
- Cover those feet. If you have numb feet, you may not notice when you step on something sharp. Avoid problems by wearing shoes or slippers with soles at all time.
Now, these at-home care tips can protect your feet. But you need face (and foot) time with me. So, if you have diabetes, make your regular appointments with your Houston podiatrist. I'll give you a thorough foot check. And, if you have any signs of a wound, we'll treat it immediately at Tanglewood Foot Specialists.