CHENNAI: Those who do not control their blood glucose level must take extra care of their feet. Injuries, a history of ulcers, amputation, altered movement of the feet and change in bone structure of toes/feet must be thoroughly investigated.

Senior vascular surgeon V. Balaji of Apollo Hospitals says educating patients could prevent 50 per cent of amputations. At least 30 per cent of the 35.5 million diabetics in India will develop foot problems, he says.

Dr. Balaji provides appalling statistics both in his hospital and the world over. The U.S. spends $98 billion annually of which $54 billion is spent on indirect support of diabetes including rehabilitation efforts. At Apollo Hospitals, on average a diabetic visiting the outpatient department spends Rs. 2,000-3,000. Inpatients spend 10 times more. An uncontrolled diabetic who needs surgical intervention may spend Rs. 1.5 lakhs. The amount spent is about 25 per cent of the annual income in the lower social group and four per cent in the higher social group. "Both the educated and the illiterate suffer" because of poor awareness about care of the body, he says. "The cost for basic evaluation is less than Rs. 1,000 but only 10 per cent agree to it."

The hospital offers assessment of blood vessels in the legs and provides medical, surgical, minimally invasive and by pass procedures, similar to those offered for blocked blood vessels of the heart. Treatment becomes expensive and results are poor when people come at later stages.

Twenty per cent of diabetics develop poor circulation problem. It is compounded when the diabetic is a smoker, hypertensive, suffers from hyperlipidity or has renal failure.

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