The surge of diabetes in India is alarming. With the disease comes its many possible complications, some of which are often ignored.
Surgeon Dr Rajnder Sharma of Kumar Hospital, Hoshiarpur, a former president of IMA, Punjab, has highlighted the growing threat of diabetes and its complications, particularly diabetic foot infections, which he described as a major but often neglected cause of suffering among patients.
Speaking to The Tribune, Dr Sharma said diabetes mellitus was fast becoming one of the leading causes of morbidity and mortality in India.
"India already has the highest number of diabetic patients in the world. At present, nearly 7.7 crore adults are suffering from diabetes, and this figure is projected to rise alarmingly to 15 crore by 2050," he said.
According to him, a sedentary lifestyle, genetic predisposition and unhealthy dietary habits are the primary reasons behind this surge.
Explaining the complications, Dr Sharma said diabetes could affect almost every part of the body, but diabetic foot infections deserved specific attention.
"Because of nerve damage, the feet often become numb. Small cuts, blisters or wounds go unnoticed and gradually turn into serious infections. Many patients reach hospitals very late, when the infection becomes life-threatening and amputation is the only option. This causes immense physical disability and severe mental stress," he said.
Dr Sharma said daily foot care was essential for diabetic patients. He advised washing feet every day with lukewarm water and mild soap, preferably before going to bed, and drying them thoroughly, especially between the toes.
Moisturising cream should be applied to the feet, but never between the toes, as moisture there can promote fungal
infections, he added.
Keeping the spaces between toes dry or using antifungal powder was imperative, he added.
He cautioned patients to never ignore any change in their feet.
"If you notice cuts, scratches, blisters, swelling or discoloration, immediately clean the area with tap water, dry it, apply an antiseptic cream and consult your doctor without delay. Ignoring such signs can be dangerous," he said, adding that numbness or tingling in the feet should also be reported immediately.
Speaking about footwear, Dr Sharma strongly advised against walking barefoot, even at home.
"Patients should avoid open sandals, and always wear well-fitting, soft footwear with cotton socks. Shoes should
neither be tight nor loose, and the inside must be smooth and
well-cushioned," he said. He also warned against wearing new shoes for long hours continuously, and stressed the
importance of checking the soles and heels daily for ulcers or blisters.
Seasonal precautions were equally important, he added. During winters, patients should avoid
sitting close to heaters or placing feet directly in front of them, as numb feet can easily get burned. Similarly, the temperature of water must always be checked before soaking feet. Hot water bottles should never be kept in direct contact with feet or legs, and should always be wrapped in a cloth.
Dr Sharma also advised patients not to cut their nails too short, as this can lead to unnoticed injuries.
He stressed that smoking must be completely avoided, as it
reduces blood supply to the legs and worsens diabetic foot problems. Alcohol should be avoided or taken only
in moderation.
During summers and the rainy season, he suggested removing shoes and socks in the afternoon to allow moisture to
dry out and gently massaging the feet. "If a foot infection develops despite precautions, it is crucial to
consult a doctor immediately and strictly follow the prescribed treatment plan," he said. Highlighting the role of lifestyle control, Dr Sharma said good blood sugar management was essential for preventing and treating diabetic
foot infections.
He advised patients to completely stop consuming sugar, sweets, deep-fried foods, white bread, 'maida' (all-purpose flour) products, deep-fried potatoes and rice 'pulao'. Brown rice or boiled rice should be preferred. Cold drinks, sweetened and alcoholic beverages must be avoided, and artificial sweeteners should be used cautiously.
He recommended a diet rich in salads and vegetables, preferably boiled, steamed or cooked in mustard or olive
oil. Seasonal fruits such as guava, papaya, apple, black grapes, kiwi, peach and pears can be taken in moderation.
Wheat intake should be reduced, and alternatives like bajra or ragi mixed flour can be used. Regular physical activity was equally important, Dr Sharma said.
"Brisk walking for 30-40 minutes daily, at least five days a week, is very
beneficial. Those with desk jobs should get up every hour and move around for a few minutes," he advised. Drinking adequate water, about 3-4 litres per day, depending on the weather, was essential too, he said.
Dr Sharma stressed that patients must keep their blood sugar levels, blood pressure and body weight under control, take medicines regularly, and strictly monitor blood sugar levels. "Equally important is mental well-being. Be happy, stay relaxed and remain tension-free," he said. He concluded with what he called the '5 As' for diabetic patients: avoid unnecessary medications; always consult your doctor regularly; allow yourself relaxation amid a busy schedule; adhere strictly to your doctor's instructions; and, above all, always be happy.