Diabetic Foot Ulcers Can Be Painless Yet Lead to Limb Loss, Warn Doctors

New Delhi, July 18: Health experts have cautioned that even the smallest cut, blister or injury on the feet can become a serious medical emergency for individuals living with diabetes if not treated promptly. Doctors say diabetic foot ulcers frequently develop without causing pain, allowing infections to spread unnoticed and significantly increasing the risk of lower limb amputations.

Raising awareness about one of the most neglected complications of diabetes, specialists at Marengo Asia Hospitals, Gurugram, highlighted that diabetic foot syndrome is largely preventable through routine screening, timely medical care and better patient awareness. To strengthen early diagnosis and preventive care, the hospital has inaugurated a dedicated Diabetic Foot Lab, designed to identify foot-related complications before ulcers develop.

India’s Growing Diabetes Burden

India continues to face one of the world’s largest diabetes challenges. According to the International Diabetes Federation (IDF) Diabetes Atlas 2025, more than 89 million adults in the country are living with diabetes, making India the second-largest diabetic population globally.

Doctors noted that as diabetes cases continue to rise, complications associated with the disease including diabetic foot disorders are also becoming increasingly common. Despite this growing burden, many patients remain unaware that minor injuries can quickly turn into life-threatening infections if left untreated.

Small Wounds Can Have Serious Consequences

Medical experts explained that diabetic foot ulcers often begin with seemingly insignificant injuries such as shoe bites, cracked skin, cuts or blisters. Unlike normal wounds, these injuries may heal slowly due to poor blood circulation and high blood sugar levels.

If treatment is delayed, bacteria can enter the wound, leading to deep tissue infections, damage to bones and, in severe cases, gangrene. Doctors warned that many diabetes-related amputations begin with a tiny wound that could have been prevented or treated successfully during its early stages.

Why Many Patients Feel No Pain

Dr. Amitabh Singh, Clinical Director and Head of Plastic Surgery at Marengo Asia Hospitals, explained that prolonged uncontrolled diabetes damages peripheral nerves, resulting in a condition known as diabetic neuropathy.

Because nerve damage reduces sensation in the feet, patients often fail to notice cuts, burns or injuries. As a result, wounds continue to worsen while remaining painless.

“Many diabetic foot ulcers start as small, painless injuries. Since patients do not experience discomfort, they frequently ignore them until infection has already spread to deeper tissues. By the time they seek medical attention, treatment becomes much more complicated,” he explained.

According to doctors, this lack of pain is one of the biggest reasons why diabetic foot ulcers are diagnosed at advanced stages.

Diabetes Also Changes Foot Structure

Apart from affecting nerves, diabetes can weaken the muscles that support the natural structure of the foot.

Doctors explained that muscle weakness may alter walking patterns, creating excessive pressure on certain areas of the foot. Constant pressure eventually damages the skin, increasing the likelihood of ulcers.

Patients with foot deformities, improper footwear or long-standing diabetes face an even higher risk of developing pressure-related wounds.

Millions Remain at Risk

Medical studies estimate that between 15 and 25 percent of individuals living with diabetes will develop a foot ulcer at some point during their lifetime.

Even more concerning, nearly 85 percent of diabetes-related lower-limb amputations are preceded by foot ulcers. Specialists say a significant proportion of these amputations could be prevented through early diagnosis, patient education and appropriate treatment.

Doctors stressed that regular foot examinations should become an essential part of diabetes management, alongside monitoring blood sugar, blood pressure and cholesterol.

Comprehensive Diabetes Care Is Essential

Harpreet Singh, Facility Director at Marengo Asia Hospitals, emphasized that managing diabetes involves much more than maintaining healthy glucose levels.

He noted that patients should also focus on preventing long-term complications affecting the eyes, kidneys, nerves, heart and feet.

According to him, diabetic foot syndrome remains one of the leading causes of preventable disability among diabetic patients. Unfortunately, the condition is frequently underdiagnosed because many people are unaware of the warning signs.

He urged healthcare providers and patients alike to prioritize routine screening, education and multidisciplinary care to reduce avoidable complications.

New Diabetic Foot Lab to Strengthen Prevention

To improve early detection, Marengo Asia Hospitals has established a dedicated Diabetic Foot Lab equipped to assess multiple risk factors before ulcers develop.

The facility will perform specialized assessments to identify:

Pressure points that increase ulcer risk.
Nerve damage affecting foot sensation.
Poor blood circulation.
Changes in walking patterns.
Early structural deformities.

Following evaluation, doctors will recommend personalized preventive measures depending on each patient’s condition.

These recommendations may include specially designed footwear, pressure-relieving insoles, physiotherapy, lifestyle modifications, wound care education or minor corrective surgical procedures when necessary.

Hospital authorities believe early intervention can significantly reduce hospital admissions, infections and amputations.

Importance of Daily Foot Care

Doctors advised people with diabetes to examine their feet every day, even if they do not experience pain.

Patients should immediately seek medical attention if they notice:

Cuts or wounds.
Blisters.
Swelling.
Redness.
Skin discoloration.
Cracked heels.
Persistent sores.
Nail infections.

Experts also recommend washing feet daily, drying them thoroughly, moisturizing dry skin while avoiding the spaces between toes, trimming nails carefully and wearing properly fitting footwear at all times.

Walking barefoot should be avoided because reduced sensation increases the likelihood of unnoticed injuries.

Need for Better Awareness Across India

Dr. Preeti Pandya, Senior Consultant in Plastic Surgery, observed that dedicated diabetic foot assessment centres have become increasingly common in several southern states over recent years.

However, she pointed out that multidisciplinary diabetic foot care facilities remain relatively limited across many parts of North India.

She emphasized the need to expand specialized screening services so patients can access preventive care before complications become severe.

According to doctors, increasing awareness among both healthcare professionals and the general public will play a vital role in reducing diabetes-related disabilities.

Early Diagnosis Can Save Limbs

Medical experts stressed that diabetic foot syndrome should no longer be viewed as an inevitable consequence of diabetes. With regular medical check-ups, proper blood sugar control, routine foot examinations and prompt treatment of even minor injuries, most serious complications can be prevented.

Doctors concluded that early detection remains the most effective strategy for protecting patients from severe infections, prolonged hospitalization and avoidable amputations. As India’s diabetic population continues to grow, preventive foot care must become an integral part of comprehensive diabetes management to improve quality of life and reduce long-term healthcare burdens.