On 28 Feb, 2026, Seniors Today hosted their weekly Health Live Webinar with Dr Raghuram Sekhar, Head of Vascular Surgery at Kokilaben Dhirubahai Ambani Hospital, Mumbai who spoke on and answered questions about Diabetic Foot Care.
About Dr Raghuram Sekhar:
Dr Raghuram Sekhar leads one of the most comprehensive vascular health programmes in Mumbai. He is among the most experienced clinicians in the city for the treatment of complex vascular diseases and has been accredited by some of the most prestigious institutions globally.
With over 29 years of experience in surgery, including 18 years dedicated to vascular surgery, Dr Sekhar is one of the few accredited vascular surgeons in India extensively trained in both open surgical and endovascular (keyhole) techniques for managing vascular diseases.
Dr Sekhar is a National Award Winner (Government of India, 2009) and has mentored several trainee vascular surgeons in India and abroad.
He has delivered over 600 national and international presentations and has more than 60 publications to his credit. He served as Editor-in-Chief of the Yearbook of Vascular & Endovascular Surgery (2016, 2018, 2020) and is a member of the editorial board of the Indian Journal of Vascular & Endovascular Surgery.
The global burden of Diabetes is as follows:
- Estimated 828 million people are affected by diabetes worldwide. The numbers are projected to rise higher as the years go by
- 1 in 9 adults, globally are affected by diabetes
- India has approximately 90- 200 million people affected with diabetes. This makes us the 2nd highest ranking country with a population after China.
- Diabetes in India affects at a younger age than in the west.
- Indian patients have a far lower BMI and are still affected by diabetes.
India is facing an unrelenting epidemic of diabetes and the future is going to be worse.
This can be attributed to our sedentary lifestyle, obesity and also due to our genetic predisposition to diabetes as a South Asian population.
Our feet are an important part of our body.
It supports the weight of our body.
It absorbs shock and impact with every step that we take. Each step puts about 150 pounds/ sq inch of pressure every time you walk.
About 15% of diabetic patients are bound to experience some kind of a foot complication.
Amputation in a diabetic foot is the most feared complication.
About 70% of non traumatic limb amputations are due to diabetes and its complications.
For 85% of the above mentioned 70% of the individuals the journey towards amputation starts from a simple wound or foot ulcer commonly looking like a shoe bite.
Diabetic patients have higher risk of developing due to:
- Neuropathy: nerves in the body have- sensory nerves that provide the sensation, motor nerves that help in the moment of muscles in a synchronised way and autonomic nerves that make our feet sweat (one of the many functions). In neuropathy all three of these nerves are affected
- Angiopathy: the blood vessels start getting clogged
- Immunopathy: diabetics have a higher risk of developing infections due to lower ability to fight infections due to a paralysed immune system. This is because the tissues are loaded with high sugar
In a diabetic patient, the perception of pain is decreased. This makes a diabetic person more susceptible to injury and also to not paint heed to the site of injury after it has occurred.
Due to less sensation in the foot, after an injury, a diabetic patient is more prone to either ignoring the injury or not being aware that you have sustained one until you start having symptoms such as pain in the foot, swelling, pus/ discharge.
Sensation in the foot is protective to us.
It usually starts as a non healing ulcer and can then lead to detrimental results.
By the time the symptoms are perceived, it is more often than not too late to salvage the foot.
Every diabetic individual has some extent of neuropathy. Patients with uncontrolled diabetes have changes in sensation. This can present as:
- Electric sensation/ burning sensation in feet
- Inability to feel the ground while waling
- Stabbing sensation
Due to motor neuropathy, the foot loses its arch, resulting in change in shape of the foot. This makes your foot more vulnerable for injury and shoe bite. It can finally result in visible bony deformity.
This needs to be treated adequately by a physician. Adequate and appropriate foot wear needs to be worn.
Avoid cutting any outgrown or misinterpreting it as a callus.
Due to involvement of an autonomous nervous system, the feet can become dry and crack, making them a more susceptible entry point for infection.
There is no cure for neuropathy. It is progressive and irreversible.
Since you can’t cure it, it is better to prevent it. This can be done by:
- Wearing adequate food wear
- Avoid walking around with bare feet
In diabetes, the feet swell due to the following causes:
- Obesity
- Kidney issues (collection of water in your dependant parts such as you feet)
- Heart issues- cardiac issues are seen in patients with diabetes. Diabetic patients are more prone to having their arteries clogged
- Hypertension
- Medication related
- Neuropathy
Dos for diabetics:
- Inspect your feet everyday for blisters, cuts.
- Look between your toes
- Moisturise your feet regularly- twice a day
- If you see an cut/ blister- consult your physician immediately
- When buying your shoes- buy them in the evening, one size larger shoe size
