What is diabetic foot?
Diabetic foot disease is one of the major, common and serious chronic and progressive complications of diabetes mellitus, which is atherosclerosis and microangiopathy of large, medium and small limb arteries in addition to cardiovascular, renal and retinal vascular lesions. It is often accompanied by peripheral neuropathy, limb ischemia, hypoxia, gangrene, infection and other lesions, and patients often lose their normal mobility. It is characterized by numbness, tingling, coldness, intermittent claudication, followed by ulceration and gangrene in the lower extremities, often leading to amputation and disability, which is called “gangrene removal” in Chinese medicine.
According to the International Diabetes Federation (IDF), the number of people with diabetes is expected to grow to 380 million worldwide by 2025, and 15% to 20% of people with diabetes will develop foot ulcers during the course of their disease. Diabetes is the number one cause of amputation in many countries, with the rate of amputation in diabetics 40 times higher than in non-diabetics, and approximately 50% or more of non-traumatic amputations are performed in diabetics, 85% of which are caused by foot ulcers.
Why is there a diabetic foot?
The development of diabetic foot disease is often the result of a series of risk factors interacting with each other. For example, peripheral neuropathy leads to decreased or absent sensation in the lower extremities, and in some patients, foreign objects in shoes or shoes that are worn too tightly break the skin of the foot under pressure and form ulcers. Poor blood circulation leads to ulcers that are difficult to heal and prone to infection, eventually leading to increased infection of the ulcer, making it difficult to heal and leading to amputation.
Chinese medicine believes that the patient is thirsty, Yin deficiency of the body, water deficiency, fire, fire toxicity, heat burning camp blood, blood stasis blockage; and thirsty people, more like cream and sorghum thick taste, resulting in dampness, wet stagnation, damp-heat intertwined, and because of external evil and trauma and other causative factors, resulting in abnormal operation of blood and Qi, stagnation of the veins, limbs lose nourishment, stasis for a long time into fire contains poison, heat toxicity burned veins and flesh, tendons and bones and gangrene, ulcers.
Manifestations of diabetic foot
Local ischemia and nutritional disorders: coldness, coldness, numbness, soreness at the end of the affected limb, limp after walking 500-1000 meters, painful swelling in the calf or sole of the affected limb, symptoms are relieved or disappear after resting for a moment, then when walking the same or shorter distance, the painful swelling in the affected limb appears again, intermittent limp becomes more and more serious, and resting pain appears, pain at night is even worse, muscle atrophy at the end of the limb, dry skin, sweat hair loss, dark red skin. Sweat hair loss, dark red or bruised skin, purple spots, weakened or disappeared dorsal foot artery pulsation; light dark tongue or petechiae, thin white moss, sunken thin or stringent pulse.
Acute infection stage: local sores with dark flesh, more necrotic flesh tissue, pus dripping, foul odor, redness and heat around the sores, severe pain, rapid development, gangrenous ulcers often spread to the foot or lower leg, or multiple penetrating sinus tracts; accompanied by fever, dry mouth, loss of appetite, short red urine, constipation; dark red or red-red-red tongue, yellowish greasy tongue or lightly flaking less moss, string or slippery pulse.
Repair and healing period: localized ulceration, exhaustion of rotting flesh, pus is scarce, the flesh buds on the sore surface are dull and not fresh, growth is slow, pain is mild, accompanied by a dull complexion, fatigue, loss of appetite, palpitation and shortness of breath, fear of cold and spontaneous sweating, the tongue is light fat or dark red, the tongue coating is thin and greasy, and the pulse is weak and thin.
Key points of health maintenance
A. Health maintenance according to the time
The main points of diabetic foot health care in accordance with the time
1. Spring.
Reasons for formation or aggravation: trekking, outing activities, etc. to foot trauma, ulcer formation.
Key points of health care: wear appropriate shoes, check the shoes for foreign objects, to prevent overexertion of the lower limbs ischemic pain aggravated.
2. Summer.
Reasons for formation or aggravation: hot, humid weather, easy to foot fungus infection, sore surface easy bacterial infection.
Main points of maintenance: wear breathable shoes, actively prevent and treat tinea pedis, keep the local sore surface and the skin around the sore clean, avoid raw water touching the wound, and avoid spicy hair products in the diet.
3. Autumn.
Reasons for formation or aggravation: dry climate, skin is prone to dryness and chapping forming wounds.
Nutritional points: the use of emollient cream, urea ointment applied externally.
4.Winter.
Formation or aggravation of the cause: heating leads to skin lesions.
Essentials of health care: avoid washing feet water temperature is too high, avoid using electric heating products for heating.
Second, dietary contraindications
1, strict control of blood sugar, avoid food that can easily make blood sugar rise
The following foods are easy to make blood sugar rise. Such as all kinds of sugar, honey, preserves, chocolate, canned fruit, soft drinks, jam, ice cream, sweet pastries and various sweet drinks, oral liquids, fruit juices, etc.
Eat more low-sugar foods, such as cereals, pumpkin, winter squash, green vegetables, peppers, eggplant, zucchini, leeks and cabbage.
In the selection of fruits, you should choose fruits with relatively low sugar content and slow rate of raising blood sugar. Plums, watermelon, oranges, lemons, grapes, kiwis, strawberries, etc., which contain less than 10 grams of sugar per 100 grams, can be used by diabetics. Bananas, pomegranates, grapefruit, oranges, apples, pears, lychees, mangoes, etc., which contain 10 grams to 20 grams of sugar, should be chosen carefully. Sugar content of more than 20 grams of dates, dried fruit, especially persimmon cake, raisins, dried apricots, dried cinnamon, etc., is prohibited.
2, use vegetable oil as cooking oil
Corn oil, sunflower oil, peanut oil, soybean oil, etc., because it is rich in polyunsaturated fatty acids, it is an essential fatty acid, in the body can help the operation of cholesterol, cholesterol deposition in the blood vessel wall, so this has a positive effect on the prevention of diabetes peripheral vascular sclerosis occlusion. It is not advisable to eat lard, butter, mutton oil, butter, cream, fatty meat and cholesterol-rich foods, and it is generally believed that the cholesterol intake should be below 300 mg per day.
3, strict prohibition of smoking and alcohol
Third, foot care
1, carefully check the feet: once a day in a bright place to thoroughly check the feet, or let family members to help check, pay attention to the toe and the palm of the foot, whether there are cracks, scratches, blisters, redness, corns, calluses, etc. Do not use their own knife, file or corrosive medicine to remove hard spots, corns and calluses. Even if the wound is very small, you should seek medical attention early.
2.Keep soft skin: You can use some emollient cream to keep the skin of your feet moist and prevent dryness.
3.Choose suitable shoes: When wearing shoes, you should look at the comfort level and choose a style with a firm heel and a wide toe; avoid wearing shoes made of artificial leather, with too sharp or too tight toes; you should choose shoes made of leather or cotton with good breathability; you can wear special protective shoes for diabetes if you have conditions. Do not wear new shoes for a long time and try to change shoes as often as possible to avoid long-term pressure on the same location of the foot and prevent blistering or bruising.
4, foot cleaning: clean your feet with warm water and soap every day, then wipe them clean with a soft dry towel, paying special attention to whether to dry between the toes. Test the water temperature with your hands before washing your feet, the water temperature should be below 40 degrees Celsius to avoid burns, do not immerse your feet in water for a long time, you can soak them in a decoction of Chinese herbal blood circulation medicine for 10 minutes to help the recovery of the blood vessels and nerve function of the feet.
5, pay attention to the warmth of the feet: choose socks made of soft natural materials, such as cotton or wool socks, avoid wearing tight nylon stockings, so as not to affect blood circulation, while socks should be changed every day.
6, to avoid trauma: trim toenails should be trimmed horizontally straight nail cutter, do not cut the toenails too short, and do not cut deep into the corner position, so as not to damage the skin; to use hot water bottles, hot pads or electric heating products to warm the feet, so as not to feel dull and burn; do not walk barefoot, walking indoors or on the carpet should also wear slippers.
7, foot massage: 1 time a day in the morning, middle and evening, 10min each time, gentle movements, should start from the tip of the toe up massage, conducive to smooth circulation.
Dietary regimen
1.Hawthorn rose tea
Ingredients: hawthorn 15g, rose 5g.
Preparation: hawthorn add 300ml of water, boil for 10 minutes and then add the rose.
Indications: Diversify the liver and Qi, activate blood and eliminate fat, suitable for early stage of gangrene.
2.Saffron and mutton soup
Ingredients: saffron 10g, lamb 250g.
Method: frying lamb frying pan, add ginger, garlic, cooking wine, stir-fry, add water 500ml and boil, add saffron stew for 30 minutes on low heat.
Indications: warming the spleen and kidney, blood circulation and pain relief, for those who are afraid of cold and pain in the lower limbs.
3.Guiqi White Pigeon Soup
Ingredients: angelica 15g, astragalus 30g, white pigeon 1.
Method: put all the ingredients together into a tile pot, add water, boil for 2 hours, seasoning can be served.
Indications: Benefiting Qi, nourishing Blood and invigorating Blood, suitable for those with gangrene sores that do not close for a long time and have Qi and Blood deficiency.