Prevention of complications in diabetic patients

    Due to the increasing incidence of diabetes, the diabetic foot, a complication of diabetes, is also increasing, accounting for almost 1/4 of the patients in the department. Although there are more methods of diabetic foot, the prognosis is significantly better than in the past, but there is no shortage of patients who lost both limbs for this reason experts call for the health of patients, should strengthen education on the prevention and treatment of diabetic foot, to achieve early prevention, early treatment, to eliminate amputation.    Auntie Zhao, 72, complained of good health, not much disease, more than 20 days ago found inexplicable blisters on the skin of the calf, at first did not care, followed by the foot began to swell up, gradually can not walk. She thought it was rheumatoid arthritis, to the hospital rheumatology department, the doctor found that the patient’s blisters soon broke, to the skin deep sink rotten, and finally rotten into two holes, considering that it may be vascular surgery disease, it is recommended to change the department for consultation. Upon examination, it was found that Auntie Zhao’s fasting blood sugar was as high as 17 (below normal 5) to have diabetes.    Lu Jiong, chief physician of vascular surgery, introduced the patient as a typical diabetic complication, only that she herself did not know that she already had diabetes, so that the skin blistered and broke down before being examined. Treatment should be mainly internal and external application of Chinese herbs and negative pressure suction to draw out the deep pus through negative pressure, which controls the development of ulcers and makes the wound recover better.    Another 78-year-old man admitted to the department has a history of diabetes for 10 years. In the past two years, he began to feel cold feet and his hands were cold when he wiped them, and even in summer, he had to cover his feet with hot water bags. Since last year, there was pain in both legs, at first it was possible to walk a few hundred meters, then completely unable to walk, thought it was lumbar spondylosis, after treatment, the effect was not significant. At the beginning of this year, when wearing new shoes, the toes were squeezed, and he rubbed himself with medicinal water, but it did not heal for a long time, instead, the symptoms worsened and developed to blackened skin of the whole double lower limbs. After angiography, it was found that the patient had extensive stenosis occlusion in both lower limbs. Due to severe ischemia, “if you don’t pass, it hurts”, resulting in pain and blackened skin. The doctors performed intravascular balloon dilation, which soon unblocked the blood vessels, and the cold sensation in the elderly’s feet gradually disappeared.    Diabetic history of about 10 years, there are complications to varying degrees, some manifested as numbness and pinprick-like pain in the nervous system of both lower extremities, some manifested as fear of cold in the lower extremities, intermittent claudication, some manifested as skin blisters, infection, etc. These symptoms are actually a manifestation of diabetic foot, at this time, general intervention can control the development of the disease. According to statistics, about 50% of diabetic patients will suffer from diabetic foot disease to varying degrees. Although there are many treatments for diabetic foot, about 40% of amputations in the affected population are due to diabetic foot gangrene.    In order to prevent the occurrence of “diabetic foot” and the health of the “second heart”, the elderly should first of all adhere to daily exercise, maintain normal weight, strictly control high blood sugar to avoid the occurrence of diabetes; eat less high-fat food, strictly control high blood fat; actively treat The first step is to exercise daily, maintain normal body weight, strictly control hyperglycemia and avoid diabetes; eat less high-fat food and strictly control high blood fat; actively treat hypertension and keep blood pressure at 130/80 mmHg. Older people should go to the hospital in time if they have blood vessel obstruction and seek scientific treatment. In addition, the elderly should be alert to fungal infections of the foot, such as beriberi, gray nails, corns, calluses, wart, etc., such as improper treatment can lead to the occurrence of “diabetic foot”.  Director Lu pointed out that the elderly should pay attention to foot hygiene and warmth in daily life, often self-examination of the foot, if the occurrence of blisters, skin cracks, abrasions, calluses, ringworm, nail infection and any other minor foot injuries and infections, do not arbitrarily self-treatment, in order to avoid the formation of ulcers or gangrene. To do a good job of foot protection, wear comfortable shoes and socks, keep your feet clean and dry, cut your toenails flat and trim the edges smooth, prevent mosquito bites, and do not cut through hard calluses or corns. Do not use too hot water to wash your feet to avoid burns. Elderly people living alone try not to use hot water bags or electric blankets to warm their feet. Older people go to the hospital once a year for a comprehensive foot examination. Only in this way can you know “feet” always happy.