Nearly 14,00,000 amputations in India is due to diabetes and only 1,00,000 are recorded per year and 50% of the patients who get amputated, face 2nd amputation within 2 years and have 70% mortality in 5 years, post amputation.
This is alarming but there is hope. Podiatric medical care reduces 80% amputation rates, said Dr Sanjay Sharma, a pioneering Podiatric Surgeon & Wound Care Specialist at an international conference on management of type II diabetes and its complications like Neuropathy, Retinopathy and Nephropathy. The conference was orgainsed by AVP Research Foundation at Coimbatore recently.
The key to prevent and manage a diabetic foot condition is ‘Offloading’. Without offloading measures, any treatment for plantar DFU is bound to fail. Offloading can be done through conservative methods with custom orthosis, footwear or total contact casts. The other option is surgical offloading for both prevention and management of DFU.
Even though offloading is not often considered in the management of diabetic foot ulceration due to lack of training, poor understanding or limited resources, Dr Sharma is of the firm opinion that it is there is no other alternative.
There are different types of offloading. The use of custom footwear for offloading is one method. Shoe modification was more commonly used as a method of offloading. Custom footwear and shoe inserts have been shown to be effective at reducing peak plantar pressures and shear forces to reduce ulcer recurrence.
Another offloading technique is the casting method. Casting can reduce pressure at the site of ulcers by 80% and heal in 6 to 8 weeks. Then there is surgery, said Dr Sharma.
Dr Sharma told the conference that foot ulceration needs effective control of infection, arterial supply and trauma avoidance. Diabetic Foot Ulcers, related amputations can be prevented, and every person with diabetes, prediabetes need to be screened for Neuropathy, Vaculopathy and Pathomecanics every year.
About Dr Sanjay Sharma
Dr Sanjay Sharma has over 18 years of experience in health care delivery, and over 10 years of experience in podiatric surgery in USA and India. He trained under Dr David Armstrong in Diabetic Foot / Limb Salvage at Banner Hospital, Arizona. USA. He is one of the 7 surgeons in India to hold a fellowship in podiatry (FFPS) from Royal College of Physicians and Surgeons, Glasgow, UK. He holds multiple patents in MedTech and Telemedicine. He is the recipient of Technology Pioneer (representing Neurosynaptic) award by World Economic Forum.