Disability due to diabetes

With a surge in lifestyle diseases becoming the talking point of health forums and policy discussions in India, diabetes, along with cardiovascular diseases and hypertension has become a central theme of discourse. However, when we talk of diabetes management, the only aspects that are focused are the need to maintain blood glucose levels, good levels of physical activity and weight control.

Little time and energy is devoted to the fact that diabetes is a major cause of
amputations, and a lot of effort needs to be put in to ensure that ulcers and injuries do not become gangrenous in diabetics.

“World Diabetes Foundation estimates that 40-70% of all lower limb amputations in the world are related to diabetes and that 85% of all diabetes related amputations begin with a foot ulcer. An overall emphasis on maintaining feet health, remaining alert for anomalies, and using orthotic devices like foot insoles, can go a long way in reducing incidence of amputations and preventing disability in diabetics,” says Mr. Amit Bhanti, Global CEO & Clinical Director, Comprehensive Prosthetics & Orthotics (CPO), a company that provides effective solutions for dealing with multiple kinds of disabilities.

“At CPO, we have a especially designed Foot Care program to help prevent foot sores by providing cushioning and support devices for the feet. If used regularly and religiously, these devices can prevent diabetes related foot complications and the resultant disability,” adds Mr Bhanti.

According to World Health Organization, over 340 million people in the world suffer from diabetes. With almost 60 million diabetics*, India today is home to the second largest population of diabetics in the world after China.
Diabetes complications include nerve damage and poor blood circulation, referred to as neuropathy. This makes the feet vulnerable to ulcers that can be extremely dangerous. Many people with diabetes lose sensation in their feet and often fail to recognize skin injuries that may develop into infected ulcers. It is often difficult to treat such skin sores which in some people lead to gangrene and necessitate amputation to save life.

Estimates by the Word Diabetes Foundation also suggest that about 40,000 lower limb amputations take place in India each year, and a large number of them are due to diabetes related complications.

“Along with diabetes prevention, it is hence important to focus on diabetes management mechanisms that include proper foot care. In cases when amputation cannot be avoided, efforts should be made to make the lives of the patients easier with advanced prosthetics. It is important to emphasize that proper diabetes management and foot care can help prevent foot ulcers. In developing countries, a major cause of foot ulcers is unsuitable shoes as well as the habit or the need to walk barefoot,” says Mr. Bhanti.

Diabetic Foot
Diabetic foot is a term used to denote feet-related complications that can arise in a person suffering from diabetes, including infection, ulcers, sores and neuropathy.

Neuropathy or nerve damage leads to loss of sensation and skin injuries often go unrecognized because of this. Due to nerve damage, sometimes changes may also occur in the shape of the feet or toes. The skin of your foot may also be affected due to diabetes. It may become dry or crack, and this may lead to infection. In extreme cases, these situations may necessitate amputation to prevent a gangrenous wound from poisoning the entire body. Sometimes, a non-healing ulcer that causes severe damage to tissues and bone may require surgical removal. Amputation may be minor (removal of toes of feet) or major (above or below the knee amputation of the leg). Amongst people who have diabetes, amputations are reported to be 15 times more common than amongst other people.

“Neuropathy makes your foot insensate to pressure. This is a dangerous situation as it can lead to a micro-trauma and joint injury to your foot which is likely to cause harm. At Comprehensive Prosthetics & Orthotics (CPO), our especially designed Foot Care program helps prevent this at the early stages of its development by aligning the foot in a neutral position and distributing the body weight evenly,” says Mr. Bhanti.

Making foot management a crucial part of diabetes management:

Take sores and injuries seriously: There is no way an injury or a skin sore can be ignored. If a foot sore hasn’t healed within a normal duration, immediately contact your doctor.

Use foot insoles and orthoses: Shoe insoles are foot support devices designed to be worn inside the shoe to lend support to your foot and prevent excessive pressure on one area. CPO manufactures custom-made insoles to suit the needs of the patients. They are often made of soft foam like substance and can slip into your shoes to provide cushioning to your feet. These are especially designed to comfortably accommodate a foot, reduce pressure on the sole and toes and keep the feet injury free. They also relieve areas of the feet that usually take excessive pressure. Even if you have been standing or walking for a long time, insoles will provide relief to your feet. For people with diabetes, this is very crucial to prevent injury or sore.

Studies and research have suggested that long term use of foot orthoses like insoles can reduce the incidence of diabetes related amputation. Such devices help reduce pressure on the foot and reduce the risk of sores or ulcers that may be the potential cause of amputation.

CPO Solutions:
CPO utilizes the most advanced technology to take 3D impressions of the patient’s foot. Using a ‘correct and confirm’ software, the scan can be modified to incorporate the necessary biomechanical corrections – making the solution customized as per the foot type. The scanner provides the flexibility to take semi and full weight bearing positions within a few minutes with utmost precision.

About Comprehensive Prosthetics & Orthotics
Comprehensive Prosthetics & Orthotics (CPO) is a US-based company. Started by Mr Amit Bhanti and Donald Goertzen in 2005 in Illinois, US, the strength of the company lies in designing and creating custom orthotic and prosthetic products using high-end technology.

CPO is an independent private practice accredited by the American Board for Certification in Orthotics, Prosthetics, and Pedorthics. It is the only full service P&O organization, having unmatched products and services.

Currently, the company has 21 clinics in the US and 7 in India. CPO has its own central fabrication unit in the US and India (Delhi). It is the premium provider of all prosthetics and orthotics products and services across India and the US.

The aim of the company is to restore mobility and quality of life to the patients and their families, and in the process become the largest and most successful global O&P Company.