Multidisciplinary approach for diabetic and leprosy feet

Leprosy Mailing List, May 8th, 2008

Ref.: Multidisciplinary approach for diabetic and leprosy feet
From: Premkumar R., Karigiri, Tamil Nadu, India


Dear Salvatore,

I would like to reply to Prof. William Faber’s message dated LML April 15th, 2008. The answer to his question is, yes; to a very large extent the knowledge and skills of we professionals involved in the care of leprosy feet, like surgeons, physio-occupational therapists and footwear technicians are also used for the care of diabetic feet at Karigiri; as well we participate in a multidisciplinary approach for diabetic feet. At Karigiri from where this letter is being sent, each Wednesday a diabetic clinic is held in which approximately 30 patients attend. The management is clinical examination of patients & chemotherapy, diet therapy, ophthalmology and foot care and it is a basic package to each diabetes patients.

As far as foot care is concerned, general examination of the feet for deformities & skin condition, sensory (biosthesiometry & monofilament) and intrinsic muscles testing, and vascularity tests are done. The above findings are used in classifying the foot into low/moderate/high risk groups. The foot management is based on these diagnoses. Management normally consists of patient education, selection of footwear, and treating pre-ulcerative condition/s i.e., reduction of callus, corns and fissures.

Last but not least, based mainly on our leprosy experiences a chapter on the footwear for diabetes was written by us in the 4th edition of a practical guide to diabetes mellitus; it is in the press. Editor – Dr. Nihal Thomas. Publishers – Academa Publishers, Delhi. Since I do not have Prof William’s address would you please send my above reply to him?

Warm greetings,
Premkumar (PhD)