You have brought out this highly relevant issue which is not being discussed often in this forum , though it is highly critical for diabetes and leg amputation is increasing at a faster rate...
(1) Podiatry check every 6 months or even more frequently is a must...
(2) ABI- Ankle Brachial Index check during podiatry will indicate if there is a blood circulation issue..
(3) Keep your feet clean , apply moisturizer often , keep it soft...clean your socks daily...
(4) you are likely to be attacked by psoriasis- itching and ulcer...consult your skin specialist and take treatment ....
(5) if you find blood circulation issue in your leg by ABI... You need to investigate and take treatment
(6) Brisk walk twice or thrice daily.. Some Yoga pose including raising leg upwards with support on back and head could help. (Sarvangasan)
(7) If you have too much aching / tired leg, check if you have venous insufficiency or vericose veins...This can be easily controlled by graduated compressed Stockings. .
(8) Most of the diabetes take Metformin as Mono or combined therapy.
Metformin is known to deplete Vitamin B12.. which could aggravate Neuropathy. Neuropathy not only could lead to neuropathic pain, but if the nerves get totally damaged, you will lose sensitivity of cold, hot , pain.... Which is dangrous.
If you are taking metformin , you need to check your vit b12 level frequently and take Vit b12 called Methylcobalamine 1500 MCG per day after consultation with your doctor. It is a water soluble vitamin and will get excreted through kidney and so no worry for toxicity. .
(9) Also keep checking hsCRP level and don't remain in an Inflammatory conditions.. seek medical help if you find your body has a lot of inflammation..
Chronic body inflammation could do many damage to the body internally..
In UK, GP practice is excellent, foot check , eye screening and blood test, HbA1c annually carried out most of the people go for it but a hand full ignore the letter!!!
You will go to the hospital for removing the dead tissue from the ulcer and also for dressing the diabetic ulcer. Some times it may happen that the ulcer can be infected by nosocomial (hospital acquired) super bug (antibiotic-resistant bacteria). This will cause more time to heal as well as incurring more expenditure for treatment. (for example: infection by Pseudomonas aerunginosa).
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