Just be rich and not sick! Stay away from diabetic foot

  Society is constantly progressing, and people’s living standards are improving every year. Since the car into the ordinary home, every family on the table on a regular basis without chicken, duck, fish and meat, every day like the New Year. Eat more, move less, coupled with the pressure of work, life is stressful, smoking and alcohol and other bad lifestyle, slowly, diabetes has become a “rich disease”, and diabetes to the late stage, most will appear a serious complication: diabetic foot!  Diabetic foot refers to the combination of neuropathy and various degrees of peripheral vascular disease in diabetic patients, resulting in lower limb infection, ulcer formation and/or deep tissue destruction. Clinically, due to long-term hyperglycemia in diabetic patients, lower extremity vascular sclerosis, thickened vessel walls, and decreased elasticity, blood vessels are prone to thrombosis and plaque formation, which further leads to lower extremity vascular occlusion and peripheral nerve damage, resulting in lower extremity tissue lesions.  The “foot” is the farthest from the heart and has the most serious occlusion, which leads to edema, blackening, decay, necrosis and gangrene. At present, major hospitals generally take amputation, bypass or dry fine chest transplantation for patients with diabetic foot.  Diabetic foot, as early as in China’s ancient medical books have been recorded, “Yellow Emperor’s Classic of Internal Medicine” recorded that “the cream beam thick taste, the foot has big boils. Modern medicine first used the term “diabetic foot” in 1956. It is believed that the disease is due to diabetic vascular disease and loss of sensation due to ischemia and neuropathy in the extremities, and the foot combined with infection is called “diabetic foot”. Diabetic foot is a systemic disease, which has both clinical manifestations of diabetic medical diseases and signs and symptoms of surgical diseases such as extremity ulceration and infection.  As most of the patients with “diabetic foot” are old, the surgical trauma surface is large, the wound is difficult to heal, and it is easy to infect and recur, and the death rate of patients after amputation is 51% within two years, the amputation rate of the inner contralateral limb is more than 50%, and the mortality rate is more than 80% within 5 years, so the traditional treatment is high risk and the effect is not ideal.  According to the latest statistics from the World Health Organization (WHO), the current global diabetic population has reached 180 million people, and this 3.6% of diabetics consume 12% + 15% of health resources. In recent years, China is a country with a high prevalence of diabetic foot, and the average hospitalization day for diabetic foot is 46 days and the average hospitalization cost is 35,000 yuan, which is about four times the average hospitalization cost for diabetes. However, research on the diabetic foot, a complication of diabetes, is still in its infancy. Currently, there is only one specialized diabetes research institute in the world, and population studies on the incidence of low-level amputations in large samples are lacking, especially in underdeveloped countries. Most studies point to an estimated annual incidence of lower extremity hypospadias of 7-206 per 100,000 inhabitants. The highest incidence has been reported in residents of Indian reservations in the United States, and the lowest incidence has been reported in residents of Denmark and some areas of the United Kingdom.  The main serious consequences of diabetic foot problems are foot ulcers and amputations. It has been established that amputation rates vary considerably from country to country and from region to region. Between 40% and 60% of all non-traumatic lower limb amputations are done in diabetic patients. It has been clinically established that approximately 85% of diabetic patients have foot ulcers prior to amputation, 50-70% of diabetic patients have gangrene at the time of amputation, and 20%-50% have co-infection. In the majority of patients, amputation is necessary because of a combination of deep infection and ischemia.  In another follow-up study of 468 patients with healed foot ulcers, the recurrence rate was 34% in the first year, 61% in the second year, and 70% in the third year, with a higher recurrence rate in patients with a history of amputation. The amputation follow-up results of the 468 patients with cured ulcers were: 3%, 10% and 12% in the first, third and fifth years, respectively; among those with a history of amputation, the re-amputation rates in the first, third and fifth years were as high as 13%, 35% and 48%.  Although diabetic foot is not as rapidly fatal as cardiovascular disease, it is prone to disability and rapid decline in quality of life. It has been reported that more than 15-19% of diabetic patients whose limbs were amputated were first diagnosed with diabetes at the time of surgical hospitalization, and it is estimated that the incidence of foot ulcers is about 4-10% of diabetic patients in developed countries. Early observation and attention to the occurrence and development of diabetic foot is of immense importance to improve the quality of life of diabetic patients and to reduce the medical burden and psychological stress of patients.