Diabetic Foot (Sugar Ka Zakham) in Pakistan: Preventing Amputation

Pakistan has the world's highest comparative adult diabetes prevalence, and the foot is where that statistic turns into a surgical ward. A systematic review and meta-analysis put the pooled prevalence of diabetic foot ulcers in Pakistan at 12.16%, but with a clear upward trend — 19.54% in the most recent period studied (2011–2022) versus 4.55% in the early 2000s (Frontiers in Public Health). Reported amputation rates among those affected in Pakistan range from 21% to 48%.

At a glance

• Pooled diabetic foot ulcer prevalence in Pakistan: 12.16%, and rising (19.54% in 2011–2022)
• Reported amputation rates of 21–48% — the highest-stakes complication of diabetes here
• The mechanism is nerve damage first: the foot stops hurting, so injuries go unnoticed
• Most amputations are preventable with daily foot checks and early treatment
• Walking barefoot — including indoors and in the mosque courtyard — is a leading cause here
• Any wound on a diabetic foot is urgent, however small it looks

Sugar pairon ko kaise nuqsan pohanchati hai

Do cheezein ek sath hoti hain, aur unhi ka mila-jula asar khatarnak hai:

• Neuropathy (aasab ka nuqsan): Pairon ka ehsaas khatam ho jata hai. Kanch, keel ya garam farsh se zakham ho jaye to dard hota hi nahi — is liye pata hi nahi chalta. Yehi sab se bara khatra hai.
• Kharab khoon ki gardish: Naliyan tang ho jati hain, khoon kam pohanchta hai, is liye zakham bharta nahi.
• Infection: Zyada sugar mein bacteria tezi se barhte hain aur jism ka difaa kamzor hota hai.

The result is a small unnoticed injury that does not heal, becomes infected, spreads to deeper tissue and bone, and ends in amputation — a chain that starts with something the person never felt.

Khatray ki nishaniyan

Nerve damage warning signs, often worse at night:

• Pairon mein sunn pan (pair sun hona), jhunjhunahat ya sui chubhne jaisa ehsaas
• Jalan ya dard, khas taur par raat ko
• Garam-thanda mehsoos na hona
• Pairon ki jild ka khushk hona aur phatna

See a doctor the same day for: any cut, blister, crack or ulcer that is not healing; redness, warmth or swelling; pus or a bad smell; skin turning black or blue; a new deformity or a foot that suddenly becomes hot and swollen without injury (possible Charcot foot); fever with any foot wound; or an ingrown toenail that has become infected.

Rozana kya karna hai — daily foot care

1. Har roz dono pairon ko dekhen — talwe, ungliyon ke darmiyan, aur eiryan. Agar jhuk kar dekhna mushkil ho to sheesha rakhen ya ghar mein kisi se dekhne ko kahen. Yeh ek minute ka kaam pair bacha sakta hai.
2. Rozana neem-garm pani se dhoyen, phir achhi tarah sukhayen — khas taur par ungliyon ke darmiyan. Pani ka darja hath ya kohni se check karen, pair se nahi — pair ka ehsaas dhoka de sakta hai
3. Moisturiser lagayen khushk jild par — lekin ungliyon ke darmiyan nahi, warna wahan fungus hota hai
4. Nakhun seedhe katen, konon se andar tak nahi. Nazar kamzor ho to kisi aur se katwayen
5. Kabhi nange pair na chalen — ghar ke andar bhi nahi, aur garam farsh, ret ya sangmarmar par to bilkul nahi
6. Joota pehnne se pehle andar hath dal kar dekhen — kankar, keel ya mudi hui astar
7. Naram, poora dhakne wala joota pehnen jo dabata na ho. Naya joota thora thora kar ke istemal karen
8. Suti moze, rozana badlen, aur aise jin ka elastic tang na ho
9. Ghattay khud na katen, na corn cap ya tezab wali cheez lagayen — yeh diabetic pair mein zakham ka aam sabab hain
10. Garam pani ki botal ya heater se pair na sekein

The wider control matters too

Foot care is local; the disease is not. Keeping HbA1c, blood pressure and lipids controlled slows the nerve and vessel damage that creates the problem in the first place — see our diabetes guide. Stopping smoking matters disproportionately here, because it directly worsens the circulation the foot depends on. Have your feet examined by a professional at least once a year, and more often with existing neuropathy — this is a formal part of diabetes care, not an optional extra.

A podiatrist is the specialist for exactly this: nail and callus care that is safe in diabetes, offloading, footwear advice and ulcer management. You can find podiatrists and foot specialists on DoctorOS, and a diabetes specialist for the underlying control.

Find care: browse podiatrists and foot care specialists near you on DoctorOS — filter by city, distance and rating, and book without a phone call.

Frequently asked questions

Choti si khraash hai, kya us ke liye bhi doctor jana zaroori hai?

Ji haan. Sugar ke mareez ke pair par koi bhi zakham "chhota" nahi hota — kyunki dard na hone ki wajah se aap ko us ki gehrai ka andaza nahi hota, aur khoon ki kam gardish us ko bharne nahi deti. Jo aaj ek khraash hai woh do hafte mein ulcer ban sakti hai. Usi din dikhayen.

Pairon mein raat ko jalan hoti hai — is ka kya matlab hai?

Yeh aksar diabetic neuropathy ki nishani hoti hai, yani sugar se aasab ka nuqsan. Is ka ilaj mojood hai, aur is se bhi ahem yeh hai ke ab aap ko rozana pair check karne ki zaroorat hai — kyunki jis pair mein jalan hoti hai, usi mein aage chal kar ehsaas khatam ho jata hai.

Can nerve damage be reversed?

Established neuropathy is usually not reversible, but good glucose control slows or halts its progression, and the pain can be treated. The realistic goal is to stop it getting worse and to protect the foot that has already lost sensation.

Are "diabetic socks" and special shoes worth the money?

Properly fitted protective footwear genuinely reduces ulcer risk in high-risk feet, and is worth it if you have neuropathy or a previous ulcer. Novelty products marketed as "diabetic" without a fitting assessment are not the same thing — get assessed rather than buying blind.

Sources

• "The prevalence of foot ulcers in diabetic patients in Pakistan: A systematic review and meta-analysis," Frontiers in Public Health — 12.16% pooled; 19.54% in 2011–2022
• "Prevalence of foot ulcers in diabetic patients in Punjab, Pakistan" (PMC) — 16.83%
• "Outcome of diabetic foot ulcers at a Tertiary Care Foot Centre in Pakistan," International Wound Journal (2025)

For practitioners: if you're a podiatrist, diabetologist or vascular surgeon in Pakistan, list your practice free on DoctorOS and start taking bookings from patients who are searching for exactly this kind of care.

Cover image: (20250417) Blood glucose meter 07 by Roy Zuo, licensed under CC BY-SA 4.0.