Are we forgetting to offload the Diabetic foot Ulcers in Rural setup?

Abstract

India has the largest number of people with diabetes in the world. Today Indian diabetic [1] population is about 61.3 millions. That means a total of 122 million foot is at risk of getting diabetic foot ulcer (DFU). Every 3 sec a new case of diabetes is diagnosed and every 30 sec a lower [2] limb is amputated somewhere due to diabetes. We know that the leading cause of ulceration in the diabetic population is increased plantar foot pressure. These ulcers are commonly present over the first Meta Carpo Phalangyeal (MCP) th joint, Ball of a great toe, 5 MCP joint and heel (Figure 2). These ulcers will heal only if there is adequate blood supply, control of infection, excellent wound care and \'offloading\' or pressure redistribution of the ulcerative area. After proper wound care in the hospital and in due course these ulcers heal and patient gets discharged. But the patient again land up in outpatient department after some time with ulcer on the same area or different area on the foot