Diabetes is a chronic condition that affects millions of people worldwide, and one of its most serious and underestimated complications involves the feet. High blood sugar levels, nerve damage, and poor circulation can lead to slow-healing wounds, infections, ulcers, and in severe cases, amputations. At Joshi Hospital, Pune, the Diabetic Foot Clinic is dedicated to preventing, diagnosing, and treating all foot-related complications in diabetic patients with a comprehensive and multidisciplinary approach.

The Diabetic Foot Clinic at Joshi Hospital focuses on early identification of foot problems, customized treatment plans, and patient education to reduce the risk of long-term complications. Timely care and regular monitoring can help prevent minor issues from progressing into major concerns. With the growing incidence of diabetes in India, specialized foot care has become essential for maintaining quality of life, mobility, and overall health.

Understanding Diabetic Foot Problems

Diabetes can cause two primary issues that increase the risk of foot complications—peripheral neuropathy and peripheral vascular disease.

1. Peripheral Neuropathy:
   High blood sugar levels can damage the nerves, especially in the feet. This leads to reduced sensation, meaning patients may not feel cuts, injuries, or blisters. Even small wounds can go unnoticed and worsen over time, increasing the risk of infection.
2. Poor Circulation (Peripheral Vascular Disease):
   Diabetes affects blood flow, especially to the lower limbs. When blood circulation is compromised, wounds take longer to heal, and the body’s ability to fight infection is reduced.

This combination of nerve damage and poor circulation makes diabetic feet extremely vulnerable. Early detection and specialized care are critical to preventing complications such as ulcers, cellulitis, gangrene, and amputations.

Conditions Managed at the Diabetic Foot Clinic

The Diabetic Foot Clinic at Joshi Hospital manages a wide range of conditions associated with diabetes, including:

• Diabetic Foot Ulcers – Open sores that develop due to pressure, friction, infection, or untreated injuries.
• Infections – These include mild skin infections to severe bone infections (osteomyelitis).
• Calluses and Corns – Thickened skin areas that can lead to ulcers if left untreated.
• Foot Deformities – Such as Charcot foot, flat feet, hammer toes, and collapsed arches.
• Peripheral Neuropathy-related issues – Loss of sensation, burning pain, tingling, and numbness.
• Vascular Disorders – Poor blood flow, cold feet, or delayed wound healing.
• Ingrown Toenails and Fungal Infections – Common in diabetic individuals and require careful, sterile management.

Comprehensive Assessment and Diagnosis

At Joshi Hospital’s Diabetic Foot Clinic, every patient undergoes a detailed assessment to identify underlying risk factors and ongoing issues. The evaluation includes:

• Foot Examination: Inspection of skin, nails, pressure points, deformities, and infection signs.
• Neurological Assessment: Testing sensation with monofilament, tuning fork, and vibration tests.
• Vascular Assessment: Evaluating pulses, Doppler studies, and checking for signs of reduced blood flow.
• Wound Evaluation: Detailed analysis of ulcers, depth, infection status, and healing potential.
• Gait & Footwear Assessment: Understanding walking patterns, pressure distribution, and shoe suitability.

This thorough evaluation helps clinicians design personalized treatment plans suited to the patient’s unique needs.

Treatment Approach

Joshi Hospital’s Diabetic Foot Clinic follows evidence-based and holistic treatment protocols to ensure the best outcomes.

1. Wound Care and Dressings
   The team uses advanced wound-care techniques, sterile dressings, and modern modalities such as negative pressure wound therapy to promote faster healing. Regular monitoring ensures that infections are controlled, and wounds heal effectively.
2. Infection Management
   Prompt treatment of infections is essential. Depending on severity, treatment may include oral medications, intravenous antibiotics, and surgical cleaning of infected tissue.
3. Offloading Solutions
   Pressure on the affected foot is one of the main reasons ulcers worsen. The clinic provides offloading methods such as specialized footwear, orthotic devices, total contact casts, and customized insoles.
4. Foot Care for Neuropathy
   Treatment includes medications for nerve pain, sensory testing, gait correction, and preventive care to avoid unnoticed injuries.
5. Vascular Support
   For patients with compromised blood flow, timely intervention is crucial. The clinic works closely with vascular specialists to improve circulation through medical management or interventional procedures.
6. Surgical Interventions (when required)
   Some cases may require minor or major surgical procedures, including debridement, drainage of abscesses, correction of deformities, and in severe cases, limb-saving surgeries.

Preventive Care and Patient Education

Preventive foot care is the foundation of diabetic foot management. Joshi Hospital’s team strongly emphasizes educating patients and their families about daily foot care, proper footwear, early warning signs, and hygiene practices.

Patients are guided on:

• Inspecting feet daily for cuts or blisters
• Keeping skin moisturized
• Avoiding sharp tools for nail trimming
• Wearing well-fitted, protective footwear
• Seeking medical help at the earliest sign of redness, swelling, or pain

Prevention reduces the risk of ulcers, infections, and amputations by a significant margin.