Diabetic foot is one of the complications of diabetes, and 50% of non-traumatic amputations are caused by diabetic foot. Therefore, detection of the prodromal symptoms of diabetic foot can lead to early treatment, which in turn can reduce the rate of amputation (toe) and improve the quality of life of diabetic friends.
The early detection of diabetic foot requires the collaboration of doctors and patients, and the early detection rate of diabetic foot can be significantly improved through the examination of the foot by patients and family members (self-examination) and the examination by doctors (other examination).
I. Self-examination: usually check the appearance of the foot and pay attention to the subtle symptoms that appear on the foot.
Appearance.
Often see whether the foot has trauma, damage; whether there is corns (calluses), blisters, rashes, etc.; whether the skin color is abnormal, such as pale or red, purple; delicate or rough skin; whether there is muscle swelling or atrophy; whether the joints are deformed; whether there is cracking when cutting toe (finger) nails, toe (finger) nail grooves red and swollen; whether the sweat hair (Cui hair) on the big toe is lost. The sole of the foot can not be observed when you can use the mirror reflection to help check, or ask family members to help observe. After exercising or walking in places with sand and gravel, go home and take off your socks to carefully check if your feet are broken.
Symptoms.
Whether there is a feeling of stepping on cotton when walking; whether there is a feeling of instability on the bottom of the foot when walking; whether there is pain in the lower extremities during walking, requiring rest to relieve the pain before continuing to walk, and reappearing after walking for a period of time; whether there is pain in both lower extremities in the resting state; under what circumstances the pain is aggravated and relieved, etc.
Second, he check: the doctor selects the appropriate examination according to the patient’s condition, so as to understand the situation of the peripheral nerves and blood vessels of the patient’s lower limbs.
1.Examination of peripheral neuropathy.
10g nylon wire examination: check the sense of touch, which is the initial screening of sensory neuropathy.
Tuning fork vibratory sensation examination: check vibratory sensation, which is the initial screening of sensory neuropathy.
Pain and temperature sensory examination: to understand the sensory nerve and part of the examination of autonomic neuropathy.
Patch test: an examination to understand autonomic neuropathy.
Sympathetic skin reaction: an examination to understand autonomic neuropathy.
Electromyography and nerve conduction function examination: an examination of the motor nerve to understand the state in which the nerve and muscle are located.
Performing the above examinations enables early detection of peripheral neuropathy when there are no symptoms, because foot symptoms are sometimes not easily detected or appear late, so timely examination is of great significance for the protection of the foot and early prevention, which can prevent problems before they occur and reduce the chances of ulcers.
2. Examination of peripheral vascular lesions.
Dorsal foot artery palpation: initial screening of lower limb vascular lesions.
Lower limb artery ultrasonography: the examination of lower limb vascular lesions can understand the endothelial state of lower limb arteries and the degree of luminal stenosis.
Lower limb angiography: The examination of lower limb vascular lesions can accurately determine the location and degree of vascular lesions, which can prepare for amputation surgery or vascular reconstruction.
It is worth noting that “contrast nephropathy” may occur during angiography, so if the patient has renal insufficiency, the angiography may have an impact on his renal function; however, if angiography is not performed, the vascular condition cannot be understood, and effective treatment plans cannot be further developed. Therefore, the specific situation should be analyzed and the lesser of two evils should be chosen as the most beneficial option for the patient.
Diabetic patients should be examined for complications annually, and if symptoms of foot lesions or some early laboratory tests are abnormal, the frequency of examination should be increased to once every six months or three months.