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Diabetic Foot is the common occurring problems in people with diabetes. The reason is people with diabetes have prolonged high blood sugar level, which can damage blood vessels and nerve. Nerve damage in turn, cause the loss of sensation in the feet. Poor diabetic control develop in foot problems known as Diabetic Neuropathy and Peripheral vascular disease, which can have serious concerns. It has been found that people living in low and middle income countries, shows the common foot disease, due to lack of awareness, barefoot walking, delay in seeking attention, and lack of physicians, who provide proper guidance.  

Diabetic Neuropathy: Uncontrolled diabetes can damage nerves causing loss of sensation in the feet like cold, hot etc. This lack of feeling is called "sensory diabetic neuropathy." Any cut or sore if left unnoticed, it will get worse and sometimes infection occurs, causing muscle damage also, which create lots of pressure on a specific part. 

Peripheral vascular disease:  Diabetes cause poor blood circulation, which increase the time of healing process of any cut or sore. Poor blood flow in the arms and legs is called "peripheral vascular disease." If any infection occurs and left untreated, will result in increased risk of developing ulcers or gangrene (the death of tissue due to a lack of blood).

Foot injuries like a minor cut, a blister, infection or a sore, which sometimes left unnoticed due to loss of feeling or nerve damage, can cause ulcers, infection or sometimes beyond this, which leads to amputation. 

Amputation- A Surgical Treatment

Most treatments required in diabetic foot, depends upon the severity of the disease. Generally a patient get those treatment, where only the dead tissues or debris, are removed to clean the wound area and further needs frequent monitoring. When the condition gets worsen or ulcers are not healing, resulting in severe damage of tissue and bone, then amputation is the only option. 

Amputation is the surgery process, in which damage tissues of toe, foot or leg part are removed and preserve the healthy tissue. Reports suggest that between 0.03% and 1.5% of patients with diabetic foot require an amputation. After surgery, monitoring is done for atleast four to six weeks, to heal the wound completely. The most recommended physician is endocrinologist, who make this surgery. 

Even after amputation, patient is advised to follow diabetes treatment plan given by doctor as sometimes People who've undergone one amputation have a higher risk of having another. Some of the factors that leads an increased risk of an amputation are uncontrolled sugar level, nerve damage in the feet (peripheral neuropathy), smoking, calluses or corns, past amputation, poor blood flow etc. 

Diabetic Foot Management 

Patient with diabetes should be careful, if any foot ulcers seen to develop. It is important to take care promptly. Reports suggest that more than 80 percent of amputations begin with foot ulcers, but taking proper precaution, diabetic foot can be managed and controlled. Some of the tips needs to follow are:

• Control blood sugar levels is important.
• Wound should be kept clean and dressed.
• Apply antibiotic creams on cuts or scratches, if appear. If cut shows any other symptoms like redness or a foul-smelling discharge, rush to doctor immediately. .
• Minor sores sometimes due to infection, causes ulcers or blisters in the feet. To prevent from getting worsen, it is advisable to get them treated at the earliest.  
• Regular foot assessment
• Dry skin should be avoided by using moisturizing soaps and lotions to keep your skin soft.
• Corns/calluses are the thickened skin generally seen in these patients, which should not try to cut or remove, but visit doctor for treatment.  

• Redness, swelling, warmth or pain are the symptoms of inflammation and infection generally seen. Needs to consult physician.
• Trim nails carefully
• Protect feet from extreme temperatures: Exposure to extreme hot and cold can be the reason for foot damage in people with diabetes.

Many reports said that foot disease affects nearly 6% of people with diabetes-1, which includes ulceration, infection or destruction of tissues in the foot, thereby affecting the quality of life and social participation. Mostly amputations start with ulcers but can be prevented with good and proper foot care and screening to assess the risk for foot complications, as said in one research.