Small discussion on diabetic foot

  Diabetes has long exceeded 40 million patients in China, and the greatest danger of diabetes is the various chronic complications it causes. Diabetic foot lesions (diabetic foot) are one of the most common and serious complications of diabetes, and an important cause of disability and death in diabetic patients. It mostly occurs in older patients with long duration and poorly controlled disease. The main clinical manifestations are foot ulceration, infection and gangrene, which can lead to amputation or even life-threatening in severe cases. According to the survey, the amputation rate of diabetic foot disease is 15 times higher than that of non-diabetic patients, and about 50% of the annual amputation patients are diabetic patients. Therefore, the theme of World Diabetes Day 2005 is “Diabetes and Podiatry”. In Western countries such as the United Kingdom and the United States, 50% and 20% of diabetic inpatients are admitted to hospitals due to diabetic foot, respectively, and although the incidence of diabetic foot in China is lower than that in Western countries, there has been a significant increase in recent years.  The onset of diabetic foot is caused by secondary infection on the basis of peripheral neuropathy and vascular disease in diabetic patients. As diabetic patients are in a state of hyperglycemia and non-enzymatic glycation of protein, combined with disorders of lipid metabolism, high viscosity and hypercoagulability of blood and the characteristics of the lower limb circulation itself, many factors make the arteries of the lower limbs of diabetic patients prone to vasculopathy; at the same time, peripheral neuropathy leads to the weakening or loss of pain sensation in the body, which is very easy to cause mechanical or temperature damage, and once damaged, the above-mentioned pathological In addition, the glucose in the sweat of diabetic patients provides a good living environment for bacteria, which can easily lead to secondary infection, and the infection is difficult to control and eventually develops into gangrene.  Diabetic foot is usually found on the metatarsal surface of the foot, especially on the 1st and 5th metatarsal heads, bunions and heels. In mild cases, there are only erosions and shallow ulcers at the lesions; after infection, the ulcers may gradually deepen and expand in size, and in severe cases, they may enter the bone and cause osteomyelitis; if combined with arterial embolism, patients may experience pain at the affected area, intermittent claudication, reduced foot temperature, and weakened or absent foot artery pulsation.  The treatment of diabetic foot prevention is more important than cure, the key is prevention, should actively do a good job of foot health care. Specific measures are as follows: (1) actively treat diabetes and strictly control hyperglycemia; (2) reasonably allocate diet and strictly control hyperlipidemia and various factors that lead to early atherosclerosis; (3) actively treat diabetes-related diseases such as hypertension, hypercoagulation and hyperuricemia; (4) improve blood circulation in the extremities and exercise appropriately, such as insisting on 30-60 minutes of calf and foot exercise every day. (5) daily inspection of the foot, if there are blisters, cracks, redness, swelling, should be immediately properly treated; (6) every night to warm water and mild soft soap to wash the feet, to test the temperature of the elbow, wash the feet for no more than 10 minutes, after washing to a soft and absorbent towel softly dry, pay special attention to dry between the toes; (7) dry skin can be applied to lanolin lotion (8) Do not walk barefoot, wear thick socks for cold feet, prohibit strong and aggressive drugs, such as iodine, etc.; do not stand in the same position for too long, do not cross your legs and sit, do not wear tight pants, so as not to impede blood flow; (9) shoes and socks should be clean and loose, soft to fit, breathable (9) shoes and socks should be clean, loose, soft and breathable, wear socks with good absorbency and change them daily, and change them promptly when they are sweaty; (10) prevent infection, if you have tinea pedis and secondary infection, wash your feet with 0.2 per thousand of potassium permanganate solution three times a day, and ask a dermatologist for early consultation and treatment. Small wounds should be found in time to seek medical attention, do not treat yourself.