With the improvement of living standard, the change of living pattern and the aging of society, diabetes has become the second killer among modern diseases, and its harm to human body is second only to cancer, which seriously threatens the life and quality of life of patients. In fact, diabetes itself is not terrible, what is terrible is the complications of diabetes, and almost all the harm brought by diabetes comes from its complications. Preventing diabetes is only our first line of defense; when this line of defense is defeated, we have a second line of defense to prevent diabetic complications; and a third line of defense to reduce disability and early death caused by chronic complications of diabetes. The diabetic foot, on the other hand, is one of the most serious of the many complications, so it is important for more people with diabetes to pay attention to the prevention and early treatment of the diabetic foot – unbeknownst to them, the diabetic foot is the real “big earthquake” for people with diabetes.
How does the diabetic foot happen?
Diabetic patients with chronically high blood sugar levels can cause a variety of complications.
1, limb neuropathy, patients appear numbness in the hands and feet, dull sensation, foot deformation, etc. Patients have a weakened sense of pain, hot and cold, resulting in patients washing their feet by hot water, wearing shoes that do not fit the foot mojave can not be perceived.
2.Because of large blood vessel lesions, the walls of blood vessels are narrowed or even blocked due to atherosclerosis, making poor blood circulation in both feet.
3, the patient’s vision is reduced, coupled with neurological decompensation, often can not be detected early foot injury or other lesions.
4, the state of hyperglycemia so that the patient’s body resistance is reduced, once the foot wound, easy to infect and not easy to heal, wound infection for a long time, tissue necrosis, toxin absorption into the body, threatening the life of patients, and ultimately only choose to amputate.
This shows that diabetes is the cause of diabetic foot and diabetic foot is the result of diabetes. Diabetic foot is more common in diabetic patients aged 60-70 years, especially those with disease duration longer than 5 years, obesity and poor glycemic control. Diabetic foot is difficult to treat, with high medical costs and a poor prognosis, causing a heavy burden to families and society.
The occurrence of diabetic foot is almost always caused by the synergistic effect of three major factors: neuropathy, ischemia, and infection. Vascular lesions play a decisive role in the development of the diabetic foot, but the ultimate cause of skin necrosis is microcirculatory dysfunction. The treatment of diabetic foot is complex and difficult, and if patients do not receive professional and reasonable treatment, they will eventually have to undergo amputation. Therefore, diabetic foot is one of the most dreaded complications for diabetic patients. Therefore, in order to avoid foot complications, good foot care and proper examination are something that diabetic patients should not ignore.
Active prevention of diabetic foot
Because diabetes is a lifelong disease, the prevention of diabetic foot is especially important, and it can be completely avoided with proper preventive care. Therefore, it is vital for diabetic patients to master some basic knowledge of diabetic foot care.
1, for a diabetic patient, “the easiest and most difficult way” is to change the lifestyle
Be sure to quit smoking; and according to the recipes arranged by doctors and dietitians with a reasonable diet; consult with your doctor for the most suitable way to exercise, and adhere to 30 minutes a day.
2.Appropriate medication
Take your medication on time according to your doctor’s requirements; monitor your blood sugar every day and record it; control your blood pressure and blood lipids.
3.Appropriate foot care
(1) Choose appropriate shoes and socks: moccasins and sports shoes are the most ideal shoes; socks should be made of cotton and wool, which are good for absorbing sweat and breathable. Socks should not be too big and do not wear socks with elastic bands. Change them daily and do not wear socks with patches or tears to prevent uneven pressure on the feet and affect blood circulation.
(2) Proper foot washing and foot care: Develop a good habit of washing your feet every day, and wash your feet with warm water (40℃) and warm soap every night, or ask your family to assist if you are not too sensitive to temperature. You can soak your feet while adding warm water, and the time spent soaking your feet should not be too long.
(3) After washing feet, carefully check the feet and toes, and use a small mirror to help check the palms of the feet, if you can’t see clearly, you can have a family member do it for you. Check the feet for cracked skin, blisters, cuts, redness, swelling, discoloration, high skin temperature, tinea pedis, corns, etc., and whether the foot artery pulsation and skin sensation is normal. After washing your feet, dry them with a soft, dry towel and be sure to dry the water stains between the toes, using a small breeze from a hairdryer to dry them if necessary.
(4) At any time, even at home, do not walk barefoot to avoid foot injuries; autumn and winter feet are prone to dryness and cracking, available emollient cream evenly applied to the surface of the foot, sweaty feet can be sprinkled with some talcum powder. Remember not to use hot water bags, electric heaters or direct fire to warm your feet after washing them in winter to avoid foot burns.
(5) If you find any problems with your feet, go to the hospital in a timely manner: if the skin is dry and cracked, cold and wet, edema, darkening, lack of sensation, toenail deformation or local redness, swelling, pain and heat, etc., may indicate that foot lesions have occurred. It is necessary to go to the hospital as soon as possible. Diabetic patients should have their feet fully examined by a specialist once a year, including sensory changes and vascular pulsations.
What is the treatment of diabetic foot?
Some diabetic foot patients do not receive scientific, reasonable and standardized treatment, and even the treatment gets worse and worse, which eventually leads to amputation; some patients still cannot heal the trauma after amputation, and need to amputate higher parts again, and more serious patients die after amputation. Especially in primary hospitals, it is not uncommon for patients with diabetic foot to get worse and worse after admission.
The treatment of the diabetic foot requires multidisciplinary collaboration, rather than “treating the foot for pain”. The diabetic foot is a concentrated manifestation of the chronic complications of diabetes in the foot. Among diabetic foot patients, more than half of them have combined neuropathy, hypertension and lower limb vascular disease, and about 1/4 of them have combined cardiovascular disease, cerebrovascular disease and renal disease. Therefore, the treatment of diabetic foot is not a simple treatment of one disease, but a comprehensive treatment involving many factors. Therefore, the treatment of diabetic foot is a common topic and a common challenge for different disciplines, such as endocrinology, neurology, vascular surgery, orthopedics, etc.
At present, diabetic patients with combined foot ulcers in China are scattered in many departments such as vascular surgery, orthopedics, general surgery, endocrinology, and Chinese medicine, and do not receive professional and comprehensive medical care and treatment. For example, internal medicine does not pay enough attention to the treatment of ulcer wounds, while surgery lacks experience in dealing with diabetes and its related complications; in addition, advanced dressings for foot ulcers are expensive and need to be preserved at low temperature, which also limits their use in clinical practice.
A person with diabetic foot, before first to quickly control the blood sugar, to ensure the nutritional status of the whole body, because most of the diabetic foot patients are older, if you need to carry out lower extremity revascularization or bypass surgery, before the surgery to carry out a comprehensive adjustment and assessment of the heart, brain, lung vessels, etc., through Doppler ultrasound for non-invasive examination of the lower extremity vessels, preoperative angiography, to clarify the vascular situation of the patient, in order to determine which treatment method to use To prepare for the treatment method. The more commonly used treatments are: lower limb revascularization or bypass bypass to restore blood flow to the lower limbs, ulcerated wounds covered with special materials (such as VSD materials) to promote their healing; lower limb autologous stem cell transplantation therapy, hyperbaric oxygen therapy and other methods have also achieved better results.
Diabetic patients are often very concerned about their blood sugar changes, but really ignore the foot lesions. As the saying goes, “A journey of a thousand miles begins with the foot.” Losing your feet means that you will have a hard time in your daily life, and no one knows this better than patients who have had their feet amputated due to diabetes. Diabetic foot is indeed a “big earthquake” for diabetic patients, and diabetic patients need to fully understand its harmful effects and prevent the occurrence of diabetic foot – the mantra that every diabetic patient is asked to keep in mind here is: ” Little untreated, Big amputation!”