India Rising….but not in a good way this time: 18% of Chennai Have Diabetes

This article from the Times of India featuring our long-time friend Dr. Vijay Viswanathan, takes us through a demographic horror story in South India and how his Legs for Life program attempts to make a difference.

Amputations due to diabetes on the rise

After his retirement from a nationalised bank in 2008, R Sampathkumar had planned an active life – which included a trip to the Himalayas , pilgrimages on foot and a monthlong tour of the river Ganga.

But a small injury on his right toe shattered his dreams. It turned into an infection and festered for several months. Soon, the skin around his legs turned black due to lack of blood supply. Doctors told Sampathkumar – a diabetic – that foot amputation was the only option. Today, Sampathkumar is dependent on his son and daughter-in-law living in an apartment that isn't wheelchairfriendly. “I will have to depend on my son and other family members to do most of my things. I feel like I have lost my independence,” he said.

Sampathkumar's story is frightfully common one, say doctors. “Increasingly, a large number of patients are loosing their legs to diabetes,” says diabetologist Dr Vijay Vishwanathan. Nearly 18% of the city is estimated to have diabetes. Nearly 20% of them develop some foot complication, studies show.

The dramatic increase of limbs amputated because of Type 2 diabetes has prompted city hospitals to initiate preventive steps. Some hospitals like Dr Vishwanathan's MV Hospital for Diabetes have foot clinics and sell specially made footwear, socks and pedicure kits. Dr Vishwanathan believes that effective foot care and patient education strategies would prevent up to 85% of injuries. Lower-limb ulcers are the most common causes for such injuries. Care can prevent infection, which can spread and quickly destroy surrounding tissues.

In some people, lower limbs are numb and they don't even realise there is an injury. To help such patients, Thambiran Heart and Vascular Institute has started a free screening programme – Leg for Life – for all diabetes patients. The hospital found that patients don't realise that they have injuries caused by cigarette butts, toys, stones or ingrown toe nail. “There is no pain so many don't come to the clinics. They have to be screened routinely,” said vascular surgeon Dr Sekar, consultant, Apollo Hospitals. “More than 80% of amputations can be saved if we detect them early,” he said.

An early treatment procedure for foot ulcer , according to Dr R Ravi Kumar, interventional radiologist at Thambiran Heart and Vascular Institute, is balloon dilatation. In this, a balloon catheter is inserted into the artery and inflated to enlarge the artery and increase the blood flow, preventing amputation of the leg. “We now do it even if it is a very small artery in the foot to increase circulation of blood,” says Dr Matthias Ulrich, from Germany. Dr Ravi Kumar adds: “All we want to do is to tell people to add a little caution to save their foot.”

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