World Diabetes Day: 10-18% of diabetic patients suffer from Diabetic Foot

Chandigarh, November 13, 2021: Diabetic Foot is a major problem in India and nearly 10-18% of diabetic patients suffer from the medical condition. When diabetes is uncontrolled, it causes complications such as diabetic foot, blindness, limb amputation, heart disease, kidney failure and even early death.

On the eve of World Diabetes Day, Dr Ravul Jindal, Director, Vascular Surgery, Fortis Hospital Mohali, explained the severity of the disease and its possible consequences. The Vascular Surgery Team led by Dr Jindal has treated several patients suffering from Diabetic Foot with excellent outcomes. Taking the example of two patients, Dr Jindal detailed out the risk factors and precautions that need to be taken.

The Patient, Rajinder Singh Munjal, aged 70, presented with gangrene affecting the first and fifth toe of the right foot. The patient was diabetic, suffering from hypertension and had a history of coronary artery bypass graft surgery (CABG) and stroke. Due to the gangrene-affected foot, the patient had severe pain, foul-smelling wound, fever, sepsis and raised creatinine. Upon examination, the patient’s femoral pulses were found to be present, but distal pulses were absent in the right leg. A CT Angiography revealed severe infra-popliteal disease which causes acute pain or cramping in the back of the lower leg (calf muscle).

The Patient, Rajinder Singh Munjal, approached Dr Jindal at Fortis Hospital, Mohali, in July this year and subsequently underwent angioplasty of the right leg. The patient’s three infra-popliteal vessels were also opened, besides the first and fifth toe of the foot was amputated to stop the infection from spreading. He was discharged after two days of the surgery. Following good rehabilitation at Fortis Hospital, Mohali, the patient is leading a normal life today and his toe infection has healed.

The Patient, Manjeet Singh, aged 67 and settled in Canada, had gangrene in the fourth and fifth toe of the right leg along with spreading cellulitis over the plantar aspect of the foot. Not satisfied with the line of treatment in Canada, the patient finally approached Dr Jindal at Fortis Mohali last month. He was diabetic and suffering from severe peripheral vascular disease. A CT Angiography of the legs showed severe disease of the right leg below the knee. The team of doctors led by Dr Jindal conducted angioplasty (ballooning) of the right leg followed by extensive debridement and amputation of all toes, barring the big toe. The patient was discharged two days after the surgery. He has now recovered completely and his toe has healed.

On available treatment options, Dr Jindal, said, “Certain tests such as Filament test, Quantitative sensory testing and nerve conduction studies are carried out for diabetic neuropathy. Anodyne Therapy System (ATS) helps eliminate painful symptoms and enhances sensation as well as balance in diabetic patients with Diabetic Peripheral Neuropathy to a large extent. Surgical foot debridement is another popular method performed in diabetic foot care. Minor debridement can be performed easily with or without local anaesthesia, but in case of extensive debridement, it requires proper infrastructure with regional or general anaesthesia in operation theatres. Patients with arterial occlusion will undergo bypass or angioplasty before debridement to improve the blood supply.”

On how to keep diabetes at bay, Dr Jindal, said, “Consume a balanced diet, follow a regular fitness regimen, keep weight under control, and abstain from tobacco-related products.”

Lauding the treatment received at Fortis Mohali, the Patient, Rajinder Singh Munjal, said, “Dr Ravul Jindal offered me the best line of treatment. I suggest Diabetic Foot surgery for people with similar health conditions.”