There are more than 100 million people in the world suffering from diabetes. The prevalence of diabetes in China is growing very fast. 10 years ago, there were only about 30 million diabetics in the world, but now, according to incomplete statistics, there are about 40 million diabetics in China alone, exceeding the total number of diabetics in Europe and the United States. It is expected that by 2010, the number of diabetics in China will reach 63 million, ranking first in the world. In developed countries, diabetes has been listed as the third most common disease after cardiovascular diseases and tumors. In western countries, 5% to 10% of diabetic patients have different degrees of foot ulcers, and 1% of diabetic patients have amputations. The dangers of diabetic foot, serious foot ulcers make patients’ quality of life seriously reduced, the treatment cost is high, the treatment time is long, and once amputated, it leads to patients’ disability. In short, the danger of diabetes and its chronic complications to human health is very serious and has attracted the great attention of the medical community worldwide.
Diabetes mellitus is a chronic metabolic disease, which is caused by the lack of insulin in the body, resulting in continuous metabolic abnormalities of blood glucose, lipids and other metabolic abnormalities in human tissues and organs, followed by lesions of the retina, kidneys, blood vessels and nervous system, manifesting as blindness, kidney failure, gangrene of the limbs, polyneuritis and so on. The diabetic foot we are going to introduce is a disease caused by a combination of neuropathy, arterial vascular disease and infection in the lower limbs. As we all know, the foot is the end of the vascular circulation of the body, and due to diabetes, the blood vessels of the lower limbs become sclerotic and occluded – like a rusty water pipe, for example – so the blood circulation is very poor, and it is difficult to heal once it breaks a little. In addition, diabetic patients with neurological damage can develop foot ulcers directly without cause. When a neurological ulcer develops, the patient is often unaware of the pain, so they are often unaware of it, thus aggravating the condition. For example, if a healthy person has a nail in his or her foot, he or she will notice it immediately, but if a diabetic with nerve damage has a nail in his or her foot, he or she will not feel it at all, and when he or she does, it will be because the foot has already started to ulcerate.
Does it mean that if diabetic patients take good care of their feet and try not to get hurt, this will prevent the occurrence of diabetic foot?
In fact, this is not the case, this is a misunderstanding, because the diabetic foot does not only refer to the patient’s feet began to appear ulcers and other symptoms, but also includes the diabetic patient began to appear numb feet, pain, walking without heel and other symptoms, some times because the evolution of the disease itself is also out of its own hands, but we should know the initial diagnosis of diabetic foot common sense, so after having diabetes we should always pay attention to We should be aware of the initial diagnosis of diabetic foot, so we should always pay attention to the health of our feet. I would like to take this opportunity to remind those who have diabetes.
When you feel the following discomfort, you should pay attention to the early symptoms of diabetic foot may be.
First, the skin temperature of the lower extremities drop cold feet, feet down after the purple
Second, there is an artery in the middle of the back of the foot can usually be touched if it can not be touched or weak pulsation, is the artery narrowed, blood circulation is not good.
Third, numbness in the foot, abnormal sensation DD including burning sensation, ankle sensation, thickening sensation, etc.
Fourth, the foot skin is dry, flaky, toenail thickening, toe pry hair loss. Toes have bruises and bruises, or even gangrene.
If a diabetic patient has the above conditions, it may have the risk of causing foot disease. Therefore, in addition to the protection of the foot, but also pay attention to the above aspects. Of course, if you do not pay attention to the protection of the foot, the possibility of foot disease will be even greater.
In the most serious cases of diabetic foot development, it is a recalcitrant ulcer, severe pain, sleepless nights, some can induce cardiovascular disease, some combined with hypoproteinemia, complicated by serious infections, minor amputations, serious cases can die. To, the lethality rate is very high.
What kind of diabetic patients are generally prone to combined diabetic foot disease?
The high-risk factors of diabetic foot are as follows.
1, diabetic patients combined with neuropathy, with sensory, motor neuropathy.
2, diabetic patients with peripheral vascular disease, such as narrowing of blood vessels, blockage.
3, foot deformity.
4.Patients who are blind or have reduced vision.
5, combined with renal pathology, especially chronic renal dysfunction.
6.The elderly.
7, the lack of knowledge of diabetes.
The specific manifestations of diabetic foot are
1, the general performance of the foot: due to neuropathy, the affected limb skin dry and sweatless; limb end tingling, burning pain, numbness, dullness or loss of sensation, sock-like changes, feet on cotton wool sense; due to limb malnutrition, muscle atrophy, flexor and extensor muscles lose the normal balance of traction tension, so that the bones sink causing interphalangeal joint bending, the formation of bowed feet, mallet toe, chicken claw toe and other foot deformities. When the patient’s bone joints and surrounding soft tissues strain, the patient continues to walk easy to cause bone joint and ligament damage, causing ischemic foot occurs.
2, the main manifestations of ischemia: common skin dystrophy muscle atrophy, dry skin elasticity is poor, by hair detachment, skin temperature decreased, there is pigmentation, limb artery pulsation is weakened or disappeared, vascular stenosis can be heard at the vascular murmur. The most typical symptoms are intermittent claudication, painful rest, and difficulty in squatting and standing up. When the patient has a break in the skin of the affected limb or spontaneous blistering after being infected, forming ulcers, gangrene or necrosis.
3, diabetic foot ulcers can be divided into neurological ulcers, ischemic ulcers and mixed ulcers according to the nature of the lesion. Neurological ulcers: neuropathy plays a major role in the etiology, with good blood circulation. This foot is usually warm, numb, and dry, with little pain and good fluctuation of the arteries in the foot. A foot with concurrent neuropathy can have two consequences: neuropathic ulcers (mainly on the plantar aspect of the foot) and neuropathic arthropathy. Foot ulcers due to ischemia alone, without neuropathy, are rare. Mixed neuro-ischemic ulcers these patients have both peripheral neuropathy and peripheral vasculopathy. The neuropathy has loss of dorsalis pedis artery fluctuations. In these patients, the foot is cold and may be accompanied by pain at rest and ulceration and gangrene at the foot edge.
So how to prevent and treat diabetic foot? First of all, prevention should be the main focus.
1, pay attention to the protection of the skin of the foot, avoid extrusion trauma, shoes and socks loose and tight appropriate. Avoid wearing small squeezed shoes.
2, daily wash feet with warm water to avoid scalding feet, keep the skin clean.
3.Tinea pedis should be treated promptly.
4.Trim the toenail with caution, do not hurt the flesh.
5.Insulin must be applied when there are complications
6.Find cold feet, abnormal sensation, intermittent limp to see a doctor in time.
Treatment is as follows.
1, in addition to strict control of blood sugar, improve the general health, to eliminate some known risk factors of vascular disease, such as treatment of hypertension, reduce blood lipids, avoid smoking, etc.
2.Apply insulin.
3.Apply antimicrobial agents, drugs to improve blood vessels and nerves at an early stage.
4.Application of internal and external Chinese herbal medicine at different stages has good effect on the treatment of this disease.
5, early treatment of ulcers and gangrene if necessary incision and drainage.