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Wednesday, March 6, 2013

What is Diabetic Foot? What are the symptoms of diabetic foot?

Diabetic Foot
Diabetic Foot

Introduction to diabetic foot

The foot is a frequent site of complication in long-standing diabetic patients. The patients usually come with diabetic foot gangrene, ie, necrosis of the foot with super-added putrefaction (The process of decay or rotting in a body). And in majority of the cases the final treatment is amputation of the foot.





What are the causes of Diabetic Foot?

Diabetic foot is mainly caused by injury to the foot followed by infection in the presence of diabetic complications like diabetic neuropathy and diabetic vascular disease.The injury may go unnoticed because most of the time it is a small injury and also because the pain can not be felt due to nerve damage (neuropathy).
Diabetic Neuropathy and Diabetic Vascular Disease
Diabetic Neuropathy and Diabetic Vascular Disease

Due to diabetic vascular diseases (diabetic macrovascular disease) in diabetes the blood supply to the foot decreases in considerable amount (ischaemia). 

Diabetic neuropathy also contributes to the formation of diabetic gangrene or ulcer because healing is delayed or hampered in areas with damaged nerve supply (neuropathy).
The extent to which either ischaemia or neuropathy develops varies from person to person.
development of diabetic ulcer and diabetic gangrene
Development of Diabetic Ulcer and Diabetic Gangrene


Clinical Features of Diabetic Foot:

Digital Gangrene
Digital Gangrene

Symptoms of diabetic foot:

1. NEUROPATHY:

  • Parasthesiae
  • Pain
  • Numbness

2. ISCHAEMIA

  • Claudication
  • Rest Pain
Diabetic Ulcer
Diabetic Ulcer

Structural Damage in Diabetic foot:

1. NEUROPATHY

  • Ulcer
  • Sepsis
  • Abscess
  • Osteomyelitis
  • Digital Gangrene
  • Charcot joint

2. ISCHAEMIA:

  • Ulcer
  • Sepsis
  • Gangrene
Charcot Foot
Charcot Foot

Treatment of Diabetic foot:

Removal of callus skin with a scalpel is usually best done by a podiatrist who has specialist training and experience in diabetic foot problems.
Effective treatment of local infection with appropriate antibiotics is essential, and may have to be continued for protracted periods; osteomyelitis may be extremely difficult to eradicate.
Charcot neuroarthropathy with disorganization of joints may cause serious deformity.
Angiography may be necessary if the foot is ischaemic or ulcers are very slow to heal. Measures to improve glycaemic control may also promote healing.
Amputation may be unavoidable if there is extensive tissue and/or bony destruction or intractable ischaemic pain at rest in a limb in which vascular reconstruction has failed or is impossible due to extensive large blood vessel disease.

Patients are asked not to carry heavy weights

Control of blood sugar is a high priority.

Prevention of diabetic foot ulcers:

Prevention is the most effective way of dealing with the problem of tissue necrosis in the diabetic foot. Advice to all diabetic patients includes:
  • Inspect feet every day
  • Wash feet every day
  • Moisturize skin if dry
  • Cut or file toenails regularly
  • Change socks or stockings every day
  • Avoid walking barefoot
  • Check footwear for foreign bodies
  • Wear suitable good-fitting shoes
  • Cover minor cuts with sterile dressings
  • Do not burst blisters
  • Avoid over-the-counter corn/callus remedies

Advice to high-risk patients is as above plus:

  • Do not attempt corn removal
  • Avoid high and low temperatures
A podiatrist is an integral part of the diabetes team to ensure regular and effective podiatry and to educate patients in care of the feet.
Specially manufactured and fitted orthotic footwear is required to prevent recurrence of ulceration and protect the feet of patients with Charcot neuroarthropathy.

4 comments:

  1. Diabetes is the life threatening disease and require urgent treatment if the the infection start spreading in the body.
    AOK Emergency Room

    ReplyDelete
  2. yes I also agree with James diabetes is serious disease and found in many people now a days.
    Emergency Room Houston

    ReplyDelete
  3. As soon as you get to know about the diabetes and detect the diabetes signs, you should start taking the balance diet and regular visit the physician so as to prevent the further damage.

    ReplyDelete

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