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Education Material for Health Care Professionals: Newsletter Version

THE FEET AND DIABETES

In Greek mythology, there was once a great warrior called Achilles. When he was a small baby, the Gods told his mother to dip him in river Styx as this would make him completely safe from any harm or injury. The mother held him up by his heels and dipped him completely in the river.



As Achilles grew up he became renowned as a fearless warrior and the fable grew that nobody could ever defeat him as nothing could ever injure him!

Until one day, another famous warrior called Paris shot a poisoned arrow which hit Achilles in his heel. This was the part of the body that had been held in the mother's hand when she had dipped him in the river and therefore was not safe from harm. The poisoned arrow did kill Achilles.



From that day onwards, any vulnerable aspect of a person, has been called as the "Achilles heel" of that person.

This could well be applied to the feet of any person with diabetes. One often tends to pay so much attention to other long term complications, that we overlook the importance of foot care in diabetes.

The importance of foot problems in a diabetic should NEVER be underestimated. It should be remembered that second highest cause of foot amputations in our country.  Moreover, if one were to see the number of indoor patients in any specialised diabetic clinic or hospital, one would find more than half are there because of some foot problem. These are also patients who need to stay in the hospital the longest and whilst with excellent management, we are able to save many feet, a significant number of these patients may be left with significant morbid deformities. The medical and socioeconomic cost to these patients and their families is mind boggling.

Due to the fact that there are usually definite precipitating factors, a vast number of the foot problems are preventable!

The vast majority of foot problems occur in those with with insensitive feet, possibly without adequate circulation and are PRECIPITATED by infection, injury, or both. Due to the fact that there are usually definite precipitating factors, a vast number of the foot problems are preventable! Even if they do occur, it is possible to "catch" them at the earliest so that the management is simpler and the morbidity minimal, if any.

 It is not just a matter of chance whether a patient gets a severe foot problem or not!  There is a lot we can do to prevent foot morbidity
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