`Covid has led to delay in treatment of chronic diseases’: Doctors flag surge in diabetic foot cases in Kashmir

Srinagar: Kashmir is witnessing a silent epidemic of diabetic complications of late.

From just one patient a month to 10-15, the endocrinologists in the valley are observing a flurry of patients with diabetic foot ulcers at hospitals post Covid-19. 

Diabetic foot ulcers are among the most common complications of patients who have diabetes mellitus which is not well controlled. It is usually the result of poor glycemic control, underlying neuropathy, peripheral vascular disease, or poor foot care.

Sample this: A middle-aged male visited the Government Specialty Hospital, Srinagar last week. He had developed a blister on his foot due to the usage of a hot water bottle.

“He was unaware of it. With time, the blister got ruptured and infected. During the examination, we checked his blood sugar levels which were around 400-500 mg/dl. He was immediately put on insulin and was put in touch with the plastic surgeon. He required amputation otherwise it could’ve turned life-threatening,” the doctor said. 

Not a day had passed, when another 50-year-old patient visited the hospital with similar symptoms. “He had neglected his blister for weeks together. As a result, the foot ulcer got ruptured and infected. He ended up with pus in the entire foot requiring amputation,” the doctor said.

The ongoing Covid-19 pandemic has presented major challenges to people with diabetes in Kashmir, particularly with late complications such as risk factors for foot ulceration.

“This week itself, I treated about 7 patients with foot ulcers out of which three needed amputations. Covid has led to delay in diagnosis and proper treatment of chronic diseases,” Dr. Mohammad Hayat Bhat, Consultant Endocrinologist at Government Superspeciality Hospital, Government Medical College, Srinagar told The Kashmir Monitor.

He said that whereas many branches of medicine adapted to telemedicine in Covid, the situation got difficult and challenging for the diabetic foot patients which often required “hands-on” treatment.

“Further lack of proper medicines and poor blood sugar control aggravated their problems. Moreover, the risk of foot ulceration and limb amputation increases with age and the duration of diabetes. Therefore, the prevention of diabetic foot is crucial, considering the negative impact on a patient’s quality of life,” Dr. Hayat said.

Both doctors and patients need to inspect the feet, the doctor explained, adding that “timely referral” is important and can be a lifesaver.

The doctor said typical symptoms for foot ulcers include: Blisters or other wounds on the foot, numbness, tingling, and pain in the legs, loss of balance, discoloration of the skin, and foul smell from the foot.

Dr. Hayat said prevention is always considered a key to good health, but not all diabetic foot disorders can be prevented.

“However, one can reduce their risk of developing diabetes ulcers by following appropriate evidence-based prevention and management protocol. People with diabetes must ascertain to control their blood sugar levels, wear well-fitted shoes, avoid treating their corn at home, and avoid smoking,” he said.