BackgroundIndia contributes approximately 42 million cases out of a global burden of 463 million cases and it is ranked fi rst in the list of the ten nations most affected with diabetes. Diabetic foot diseases including Diabetic foot ulceration (DFU) are common complications among poorly managed or long duration diabetes patients in India. Diabetic foot affects approximately 15% of diabetic patients during their lifetime [1]. Among diabetes patients peripheral nerve damages often occur leading to loss of pain sensation, and damages to skin by pressure or injury leading the ulceration without their knowledge. Foot ulceration and its poor management leads to 85 percent of diabetesrelated amputations of lower limbs. Individual characteristics like overweight, alcohol and tobacco consumption accelerate the process of foot ulcers development. Vascular disease can complicate a foot ulcer, reducing the body's ability to heal and increasing the risk for an infection. Consistent high blood glucose levels reduce the body's ability to fi ght off a potential infection and delays the healing process. Several social and cultural practices like barefoot walking, squatting on the fl oor for long hours by certain professionals like tailors, priests, house maids etc. add to risk factors. Inadequate facilities for diabetes screening, blood sugar monitoring and management and foot care on one hand and use of the available facilities for diabetes care and education, and poor socioeconomic conditions are the main causes for foot ulcers in developing countries including India.
Case presentationA young woman of thirty-eight-year-old, tailor by profession, reported with an oozing swelling over left malleolus (ankle) in January 2020. She is used to sit on the ground, crossed legs on fl oor for cutting the clothes for stitching. The posture led to lot of pressure on the left lateral (malleolus) at the knob on outside of the ankle. She was a known type 2 diabetic since April 2019 on oral anti-diabetic's therapy and