Diabetic Foot Management
Diabetic foot complications are the leading cause of non-traumatic amputation worldwide — yet most are preventable with proper care. Our multidisciplinary foot care team combines vascular surgery, podiatry, and wound management to save limbs and restore mobility.
Overview
Diabetes damages feet through two mechanisms: peripheral neuropathy (nerve damage causing loss of sensation) and peripheral arterial disease (narrowed blood vessels reducing blood flow). Together, they create a dangerous scenario where a minor injury — a blister, a cut, or an ingrown toenail — goes unnoticed because the patient cannot feel it, and then fails to heal due to poor circulation.
Our comprehensive approach includes regular foot screening for all diabetic patients, aggressive wound care with specialised dressings, surgical debridement when needed, revascularisation procedures (angioplasty or bypass) to restore blood flow, custom diabetic footwear, and patient education. The goal is prevention first, limb salvage when complications occur, and amputation only as an absolute last resort.
Causes
- Peripheral neuropathy — high blood sugar damages nerves, causing loss of protective sensation
- Peripheral arterial disease — diabetes accelerates atherosclerosis, reducing blood flow to the feet
- Poor glycaemic control — elevated HbA1c impairs wound healing
- Foot deformities — bunions, hammer toes creating pressure points
- Ill-fitting footwear — a leading preventable cause of ulcers
- Previous foot ulcer or amputation — highest risk factor for recurrence
Symptoms
- Open sore or wound on the foot that does not heal within days
- Drainage or pus from the wound
- Redness, swelling, and warmth around the ulcer
- Black or dead tissue (gangrene)
- Loss of sensation — inability to feel light touch or pinprick
- Cold feet with weak or absent pulses
- Odour from the wound
Diagnosis
- Monofilament test — assesses protective sensation in the feet
- Ankle-brachial index (ABI) — measures blood flow to the lower limbs
- Colour Doppler ultrasound — maps arterial circulation
- X-ray — checks for underlying bone infection (osteomyelitis)
- Wound culture and sensitivity — identifies the specific bacteria
- CT angiography — for surgical planning when revascularisation is needed
Treatment Options
Debridement and advanced wound care
Removal of dead tissue with specialised dressings. Weekly wound clinic follow-up to monitor healing.
Offloading
Special shoes, total contact casts, or braces to remove pressure from the ulcer.
Angioplasty or bypass surgery
Restoring blood flow to the foot through minimally invasive or open vascular procedures.
Hyperbaric Oxygen Therapy (HBOT)
100% oxygen delivered under pressure to accelerate healing of chronic wounds.
Custom diabetic footwear
Therapeutic shoes with pressure-redistributing insoles to prevent ulcer recurrence.
Frequently Asked Questions
How often should a diabetic patient have their feet examined?
All diabetics should have a professional foot exam at least once a year. Those with neuropathy, poor circulation, or previous ulcers need exams every 3-6 months.
Can diabetic foot ulcers be prevented?
Yes. Daily foot inspection, proper footwear, good blood sugar control, never walking barefoot, and regular podiatry visits can prevent up to 85% of diabetic foot ulcers.
Is amputation always necessary for diabetic gangrene?
No. Early intervention with revascularisation and wound care can often save the limb. Amputation is reserved for cases where the tissue is irreversibly dead and poses a risk of life-threatening sepsis.
Ready to Discuss Your Treatment?
Our diabetic foot management specialists in Kondapur are here to help. Most consultations available within 24 hours.