Diabetic Amputations and Socioeconomic Status: The Evil Equalizer

This terrific article from Radha Shama and the Times of India

AHMEDABAD: A study has negated the common belief that only poor diabetics – who do not wear proper footwear – end up getting ulcers or infection in their feet. If not attended to in time, that complication necessitates amputation. It has been found that most upper-middle-class patients who prefer not to use footwear at home or do not take adequate care of their feet are at an equal risk of getting foot ulcers. 

“We carried out a study in which 1,000 diabetics were studied at a clinic in east Ahmedabad and posh western parts of the city,” said diabetes specialist Dr Banshi Saboo, who co-authored the study with physician Dr Urman Dhruv. “Of these, 131 diabetics were found with foot ulcers. Significantly, while 59 per cent were poor, 41 per cent belonged to upper-middle-class families.” 

Doctors said that proper footwear was an important intervention all diabetics needed to make as most injuries were related to footwear. “Of 131 patients, 70 per cent had external trauma, of which 61 per cent were footwear-related injuries,” said Dr Saboo. 

Patients need to take extreme care of diabetic foot as its treatment is long and expensive. “Nearly 20 per cent patients required hospitalization for a month,” said Dr Saboo. 

“Six patients required partial amputation, one needed amputation till knee, while six patients lost their life to this complication.” 

Doctors also found patients to have complications involving the vascular system of the legs, especially in upper-middle-class patients. “Rich diabetics lead an extremely sedentary life which involves the use of cars or two-wheelers, resulting in little walking,” said Dr Saboo. “Such patients also develop complications of less or compromised blood supply in leg veins.”

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