Diabetic patients are increasing day by day, pay attention to prevent diabetic foot disease!

  In recent years, with the gradual improvement of material living standards, the incidence of diabetes has also been increasing, and there is a trend of continuous rejuvenation. With the development of diabetes, damage to the peripheral blood vessels and nerves gradually appears in the lower extremities, at which point, a common complication of diabetics: diabetic foot disease is likely to occur.  Diabetic foot is a general term for foot pain, deep skin ulcers, and gangrene of the extremities caused by a combination of diabetic factors, and is a foot infection, ulcer and/or deep tissue destruction associated with distal nerve abnormalities and varying degrees of peripheral vascular disease in the lower extremities.Oakley first introduced the term diabetic foot in 1956; Catterall defined the diabetic foot in 1972 as “A foot that has lost sensation due to neuropathy and vitality due to ischemia, combined with infection, is called a diabetic foot” and is one of the chronic complications of diabetes and one of the leading causes of disability and death in diabetic patients. The main clinical manifestations are foot ulcers and gangrene, and serious cases require amputation.  Diabetic foot is one of the common chronic comorbidities of diabetes mellitus, and is also the main cause of amputation and disability in diabetic patients. Diabetic vasculopathy and neuropathy are the basic causes of diabetic foot comorbidity, and diabetic feet are particularly susceptible to vascular and neuropathy. Diabetic vasculopathy and neuropathy interact with each other to cause a series of clinical foot diseases, including toe disease, callus formation, skin damage and foot ulcers, and musculoskeletal lesions leading to foot deformation. Diabetics are often susceptible to trauma due to neuropathy leading to foot dissipation or decompensation, and minor trauma can quickly lead to ulceration, infection, and gangrene that eventually necessitates amputation.  The incidence of diabetic foot has increased significantly, which is related to the following factors: 1, the global increase in the number of people with diabetes.  2. the increase in the life expectancy of diabetes and the duration of diabetes.  3. the increase in the aging population.  The prevalence of diabetic foot reports vary from country to country, accounting for about 6-12% of hospitalized diabetic patients, the United States each year more than 40,000 diabetic amputees, in fact, 50% of non-traumatic amputations for diabetics, the risk of lower limb amputation for diabetics for non-diabetics 15 times.  Patients and inexperienced physicians often focus only on diabetic foot ulcers, which can lead to the dreadful end of amputation, and pay little attention to small neurological damages, but they are more common and can cause functional foot damage that can be prevented through patient education and early treatment.  Risk factors for diabetic foot: 1. duration of diabetes for more than 10 years; 2. poor long-term glycemic control; 3. wearing inappropriate shoes and poor foot hygiene care; 4. previous history of foot ulcers; 5. symptoms of neuropathy (numbness, decreased or absent sensation of touch or pain in the foot) and/or ischemic vasculopathy (pain or chills in the gastrocnemius muscle due to exercise); 6. signs of neuropathy (foot fever, skin no sweating, muscle atrophy, eagle’s claw-like toe, thickened skin at pressure points, good pulse, good blood filling) and/or signs of peripheral vascular disease (cold feet, thinning shiny skin, loss of pulse and atrophy of subcutaneous tissue); 7. other chronic complications of diabetes (severe renal failure or renal transplantation, significant retinopathy); 8. neurological and/or vascular lesions that are not severe and the presence of severe 9. other risk factors (vision loss, orthopedic problems affecting foot function such as arthritis of the knee, hip or spine, inappropriate footwear); 10. personal factors (poor socioeconomic conditions, old age or living alone, refusal of treatment and care; smoking, alcohol abuse, etc.); 11. delayed diagnosis of diabetes.  The frequency of follow-up of diabetic foot should depend on the type and extent of the condition. For example, patients with plantar ulcers should be followed up more frequently, and can be reviewed once every 1 to 3 weeks; patients with sensory loss of the foot can be followed up every 3 months.  The general principles of treatment for diabetic foot gangrene are: strict control of blood sugar; local debridement, strengthening foot care; restriction of activity, anti-infection; vascular lesions ischemic foot ulcers, not serious, can use vasodilator drugs, serious cases of revascularization; neuropathic foot, should actively improve neurological function, but whether ischemic or neuropathic foot ulcers, if gangrene still occurs despite active conservative treatment, should be promptly and decisively amputation.  Once the diabetic foot disease occurs, it is necessary to go to the diabetic foot disease specialist treatment center, by the specialist experience and qualified physicians for consultation and treatment, in order to get a comprehensive, series of comprehensive treatment, do not avoid taboo, self-treatment, or blindly believe in folk recipes, missed treatment opportunities, resulting in infection and even amputation of serious consequences.