Diabetes How To Notice Treat And Prevent Amputation in Time
With diabetes mellitus, due to prolonged elevated blood glucose levels, in the lower extremities, as in any other organ, vascular and nerve damage occurs. Simply put, they seem to be "candied". At the same time, any sensitivity in the legs decreases (pain, temperature, tactile, vibration). Against this background, even the most minor injuries to the feet (bruises, cracks, calluses, scuffs, burrs, damage caused by careless nail cutting) can lead to serious problems.
The situation is aggravated by the fact that many injuries often go unnoticed, and when the patient reaches the doctor, the disease has already reached its apogee. After the abrasion to which the infection has joined increases in size, it becomes much more difficult to treat it. An infected ulcer provokes an increase in blood sugar, which, in turn, has a bad effect on healing.
As a result, ulcerative foot defects, chronic, long-term non-healing purulent wounds, infectious bone damage (osteomyelitis) and, ultimately, gangrene occur. If effective measures are not taken in time, this can lead to amputation of the legs.
Two - faced Janus
Depending on what is more affected – blood vessels or nerves, the disease has two varieties.
Ischemic foot is a disease in which vessels mainly suffer. For such a diabetic foot , the following signs are characteristic:
• the skin on the foot and lower leg is cold;
• the skin has a pale or mottled /marbled/ color;
• there is no hair on the shin;
• the patient complains of pain that occurs when walking (intermittent lameness), and in later stages the pain persists at rest;
• painful ulcers occur along the edge of the foot, on the fingertips and in the heel area.
If the nerves, not the vessels, are mainly affected, then the disease is called neuropathic foot.
At the same time:
• the foot is warm or hot to the touch;
• there are stabbing or burning pains in the legs (more at rest, at night);
• all types of sensitivity of the lower extremities (pain, tactile, vibration, temperature) are reduced, and in the future are absent. This condition favors the occurrence of minor injuries of the skin, burns;
• hyperkeratosis (keratinization of the skin) is observed on the foot in areas of high pressure;
• there are painless ulcers on the foot.
There is also a type of neuropathic foot, in which changes in the bone structures of the limb develop – this is the so-called osteoarthropathic foot (Charcot's foot). As a result of such changes, spontaneous fractures, pronounced deformities of the bone may occur in patients, and in the future, non-healing ulcers develop on the foot.
If you find yourself with any of these signs, then you need to urgently contact a specialist in the Diabetic Foot office, where an examination will be performed to identify the nature and extent of the lesions, as well as recommendations for their treatment.
So as not to stretch your legs
First of all, it is necessary to normalize blood sugar, conduct regular examinations (measure the vibration, tactile and temperature sensitivity of the lower extremities, ideally at each visit to the doctor) and follow the rules of foot care and timely treatment of all defects.
Doctors analyzed various cases of diabetic foot syndrome. As a result, they identified the immediate causes of gangrene, and based on this, they developed special rules for foot care. The application of these rules in people with pre-existing initial leg lesions has reduced the number of amputations by 80%.
• Wash your feet daily with warm water, then wipe them with a soft towel, not forgetting the interdigital spaces.
• In the presence of keratinized skin, treat such areas with pumice stone. In no case do not use a blade or scissors for this purpose.
• If the skin of the feet is dry, lubricate them with a bold foot cream after washing, excluding the areas of the interdigital spaces.
• Treat your nails very carefully – cut them straight, without rounding the corners, and better file them with a nail file.
• Inspect the feet of the feet daily to prevent the development of damage, cracks and abrasions. It is convenient to inspect the sole with a mirror placed on the floor.
• Change socks and stockings daily.
• To warm your feet, use warm socks without tight elastic bands, and not a hot water bottle or hot water, since due to a decrease in sensitivity, you can get a burn.
• Inspect the shoes daily: whether there is a foreign object in it, whether the insole is wrapped. All this can lead to scuffing of the skin of the feet, which cannot be allowed in any way.
Never go barefoot, and do not put shoes on bare feet.
• Choose the right shoes in the store. Do not buy hard, narrow shoes. If sensitivity decreases, go shopping with a cardboard print of your foot (a cardboard insole).
• Do vascular exercises daily for the shins and feet.
• Lace up your shoes correctly – the lacing should be parallel.
• If there is a fungal lesion of the nails or the skin of the feet, it is necessary to use special antimycotic agents.
• If the skin is damaged (crack, scratch, cut), use colorless antiseptic solutions for treatment.
• In case of non-healing injuries of the foot, it is necessary to consult a doctor immediately.
By the way
Back at the desk. It is important that from the first days of diabetes mellitus, the patient has the right ideas about what to do to avoid unpleasant consequences, because the success of the fight against possible complications of diabetes will depend on his correct regular actions.
At the moment, a large number of studies on diabetes control have been conducted in the world. All of them proved that complications of diabetes mellitus can be avoided and live like a healthy person, but only on condition that the patient learns to manage diabetes himself, coexist with him in the world and maintain blood sugar at a normal level. All this can be learned in the "DIABETES SCHOOL". Such schools exist in large cities, usually on the basis of polyclinics and medical centers. The training there is completely free. You can always find out the address from the district endocrinologist. There are also online schools where you can also get all the necessary information.
Diabetic foot syndrome is just one of the links in the chain in which diabetes tries to chain its prisoners, therefore, in addition to the rules of foot care, other recommendations of doctors must be strictly followed.