Foot diabetic: signs, treatment and prevention
A diabetic foot is a term used to characterize a number of complications of a disease called diabetes mellitus. In general, this pathology is considered as a syndrome, accompanied by a group of diverse manifestations that have a direct effect on the peripheral nervous system and the blood vessels of the foot. This pathology is one of the primary causes of limb amputation.
Diabetes mellitus is a disease associated with impaired production of the hormone insulin. As a result, a steady increase in blood sugar levels is forming. The disease is characterized by a chronic course and disorders at the level of metabolic processes in the body. According to the available statistical information, the number of patients with diabetes is steadily increasing from year to year. Currently, 7.5% of the entire terrestrial population suffers from this pathology.
Diabetes is a very serious disease, almost always entailing the development of complications. Experts do not undertake to call them exact dates. However, they warn that absolutely every person can somewhat shift the time of appearance of primary complications, moreover, up or down. If there is a negligent attitude toward one’s own health, periodic neglect of treatment, the likelihood of the development of new problems increases significantly.
What is diabetic foot syndrome?
This is a generalized concept for a group of late complications of diabetes. In this pathology, patients develop abnormal changes in the feet in the form of necrotic processes of a purulent nature, ulcers, and bone and joint injuries. Most often, this syndrome is diagnosed in patients with type II diabetes, and the older age group. Based on what kind of damage occurs (vascular / nervous), there are two of its forms: ischemic and neuropathic.
Diabetic foot syndrome is the main factor that later provokes limb amputation. This pathology is confirmed in 5-10% of patients, but 50% are at risk.
Depending on the dominant pathological component, two forms of the syndrome are distinguished: ischemic (10% of cases of morbidity) and neuropathic (60-70%). Also, a mixed variant is often diagnosed - a neuroischemic form (20-30% of cases).
- The ischemic variant of the syndrome is accompanied by a violation of the normal blood supply to the extremities, which occurs as a result of the defeat of small / large vessels. Patients have a pronounced swelling, pain in the legs, skin pigmentation, fatigue.
- The neuropathic form is characterized by damage to the nervous apparatus in the zone of the so-called distal parts. Patients most often complain of dry skin, a decrease in tactile sensitivity in this area, the development of flatfoot and spontaneous fractures.
- Mixed form combines all the above manifestations.
Currently, experts have identified another classification of such a common problem as a diabetic foot. The stages of this pathology are determined based on the severity of the lesion.
- Stage 0. There are no signs of violation of the integrity of the skin, but there is a deformation of the foot, weakening of sensitivity.
- Stage 1.At this stage, a superficial ulcer with no signs of infection appears.
- Stage 2. Ulcerative defect that spreads to soft tissues.
- Stage 3. An ulcer with signs of a deep infection. Patients have reddening of the skin, severe swelling, and an increase in temperature in the affected area.
- Stage 4. Gangrene develops, which is most often combined with impaired blood flow and infectious inflammation.
Thus, a diabetic foot develops (photo).
The initial stage of the pathology in each patient can be diagnosed at different times from the moment the main disease appears. For example, in patients with type I diabetes, the problem occurs after 7-10 years.
Problems that may accompany pathology
- Mycosis. This is a fungal disease, accompanied by itching and redness of the skin. Nail plates become a yellowish-brown shade, thicken, become brittle. In some cases, there is complete destruction of the nail.
- Corns. This is the hardening of the skin in some areas of the foot due to improper distribution of weight of the person. To eliminate the corns, as a rule, special ointments and creams are prescribed.
- Ulcers. Represent infected deep wounds on the skin.In patients with diabetes, ulcers form even with minor skin lesions.
- Thumbs up. This pathology is formed due to the inflammatory process in the region of the articular sac. In this case, there is a deformity of the metatarsophalangeal joint. In case of severe pain syndrome, the decision is made on surgical intervention.
Diabetic foot disease is a rather complex mechanism of a combination of different processes. With a long course of diabetes, when there are sharp jumps in the indicators of sugar, there is a consistent deformation of blood vessels in the whole body. Pathology begins its development with the destruction of small capillaries and ends with a total disruption of the blood supply. As a result, abnormalities occur at the level of metabolic processes in tissues, including the skin.
In addition, a diabetic foot can be diagnosed for the following reasons:
- Wearing unsuitable size shoes.
- The duration of the underlying disease (the more “experience”, the higher the likelihood of developing pathology).
- Improper care of the feet.
- Bad habits.
- Fungal lesions of the feet.
- Early ulcers and amputations.
- Venous insufficiency.
Symptoms of ischemic form
What are the signs of diabetic foot? The initial stage is characterized by the appearance of pain while walking. In addition, patients complain of so-called intermittent claudication. It occurs on the background of pain and as a result of insufficient blood supply to the lower limb area with constant physical exertion. Subsequently, swelling of the foot develops. She herself becomes pale and cold. In arteries, the pulsation is usually partially or completely absent. When viewed from the skin, you can see traces of pigmentation.
A typical manifestation of the pathology is also considered the occurrence of cracks and corns. Then, on the site of localization of these formations, the formation of the sores begins.
A diabetic foot of this form is manifested in four stages. They are determined solely on the basis of the distance the patient has passed a certain distance. For example, the first stage is characterized by overcoming a distance of one kilometer in the absence of pain.The distance of 200 meters determines the second stage, and less than 200 meters - the third, etc. In the case of the fourth stage (a critical form of pathology) necrosis of the toes develops, due to which gangrene of the foot or even the entire tibia is formed.
In gangrene, the affected skin acquires a dark shade, which indicates the complex dying off of tissues.
What does a diabetic foot look like? Photos and signs of neuropathic disease
This form is accompanied by the formation of a pathological process mainly in those areas of the foot that are more under pressure. In this case, it is primarily about the interphalangeal areas, as well as the thumb. In these zones, calluses form first, and then an ulcer forms under them. In addition, deep cracks appear on the foot itself.
Charcot's joint is one of the options for how a diabetic foot can develop (photo). The initial stage of the pathology in this case is characterized by the development of destructive processes with the direct lesion of the osteo-articular apparatus. Patients complain of spontaneous fractures, swelling and deformity of the joints.
Neuropathic edema is characterized by the consequent accumulation of fluid in the tissues. Some forms of this type of pathology are characterized by the preservation of normal pulsation in the arteries, and the sensitivity of the affected area and reflexes are reduced. Ulcers are formed exclusively in those areas that are more prone to physical exertion.
This kind of pathology is considered the most serious of its form. The formation of gangrene begins on the background of severe circulatory disorders not only in the foot, but also in the lower leg. Moreover, a so-called anaerobic infection joins this process. The development of such a pathological process occurs at a rapid pace, and in some cases it even entails the death of the patient. Treatment of diabetic feet with gangrene implies amputation in almost all cases. Additionally, a course of antibiotics of a wide range of actions can be prescribed.
Diagnosis of diabetic foot is diverse. This means that the patient needs to undergo a consultation simultaneously with several specialists.A huge role in this pathology is self-examination. The patient needs to pay attention to the following signs of diabetic foot: constant dryness of the skin, their thickening and change in the usual color, deformation of the fingers, fungal lesions, swelling and pain. If all of the above symptoms appear, you should consult with your doctor.
The doctor during the first consultation collects the patient’s history, specifies exactly how long the underlying disease (diabetes mellitus) lasts, the presence of pain, the results of previous treatment, as well as the presence of associated complications (damage to eyes, kidneys, etc.).
Then a general inspection is carried out: the color of the skin, their integrity, the presence of deformities, the assessment of sensitivity. The main role in the diagnosis belongs to the results of clinical studies (indicators of glucose, cholesterol, hemoglobin level in the blood, sugar in the urine). All patients, without exception, additionally appointed examination by a neurologist, an ophthalmologist and an endocrinologist.
Diabetic foot, the photo of which can be viewed in medical reference books,In the ischemic form, the following diagnostic measures are mandatory: X-ray contrast angiography, USDG of the vessels, CT arteriography. In the presence of ulcers, a piece of tissue is taken to study the microflora.
What should be the treatment?
The earlier the appropriate therapy is prescribed to the patient, the better the result will be. It may be conservative or operational.
Conservative treatment is primarily aimed at normalizing blood sugar levels. For these purposes, apply insulin or so-called hypoglycemic agents. In addition, the treatment of diabetic feet involves the use of antibiotics. They are always appointed strictly on an individual basis and only after receiving the results of laboratory tests. In some cases, painkillers are used to reduce the manifestation of the primary symptoms: Ibuprofen, Diclofenac, Analgin. The following agents can be used to improve blood flow through the vessels: "Pentoxifylline", "Agapurin", "Normen".
A diabetic foot in some cases requires surgery.It may include the following surgical procedures:
- Removal of small areas of necrosis.
- Angioplasty - restoration of normal vascular permeability.
- Autovenous shunting. During this operation, the doctor creates additional branches of the blood flow from small fragments of the patient’s veins.
- Endarterectomy (complete removal of non-repairable vessels and subsequent triggering of blood flow along additional branches).
- Artery stenting The procedure involves the installation on the vascular walls of special nets, thanks to which the vessels are supported from abscission.
- Resection of the gangrenous area (removal of the affected finger or part of it).
- Complete amputation.
The main indication for amputation is considered to be a purulent inflammatory process that spreads to the bones of the foot, and the simultaneous critical decrease in tissue blood supply in a given area. As a rule, high amputation is performed, that is, the limb is removed approximately at the level of the upper third of the thigh or its middle. Of course, this kind of operation makes a person an invalid.Subsequently, work and self-care become difficult. That is why every patient with a diagnosis of diabetes should know preventive measures and follow them clearly to prevent the development of diabetic foot.
Help traditional medicine
How to treat a diabetic foot at home? Therapy with folk remedies is relevant only if the patient does not have a threat of gangrene or indications for surgical intervention. It is important to understand that self-treatment often leads to the occurrence of complications and a general deterioration of health. That is why you must first consult with your doctor.
The basic principles of using various kinds of medicinal herbs at home are as follows:
- The treatment allows the use of recipes with a cleansing and neutralizing effect, which are used only locally.
- Preference should be given to grass gathering with a vasodilating effect.
- Folk recipes with products that are responsible for blood thinning and improving its microcirculation have proven themselves well.
Below are the most popular treatment options.
- Blueberries have the ability to reduce blood sugar levels, accelerate all metabolic processes in the body. Experts recommend eating three cups of these berries daily, divided in equal proportions. Moreover, you can brew blueberry leaves and drink as tea.
- Leaves of burdock or burdock are characterized by wound healing effect. In winter, it is recommended to use dry mixtures of herbs that can be purchased at almost every pharmacy. The leaves are applied to the affected area, previously the center of the diabetic foot should be washed with potassium permanganate. It is recommended to change the bandage twice a day.
- A great alternative to burdock is clove oil. It is also sold in pharmacy chains. Clove has an antibacterial and analgesic effect.
- To speed up the wound healing process, the most common kefir can be applied to the integuments, and sprinkled with dry powder of juniper needles on top. The healing properties of this plant are known for a long time. Juniper is an antioxidant, contains essential oils in needles and vitamins, accelerating the healing process of wounds.
Unfortunately, it is not always possible to forget about such a problem as a diabetic foot with such simple methods. Photos of pathological lesions of the lower extremities clearly prove this statement. If folk recipes for a long time do not give a tangible result, an urgent need to consult with your doctor.
According to experts, approximately 50% of patients with diabetes mellitus are at risk. Diabetic foot develops only in 10% of cases. In 45% of them, treatment implies a complete amputation of the leg due to a late visit to a doctor. However, with timely treatment and compliance with all recommendations from specialists, the risk of re-formation of gangrene is no more than one percent.
Possible complications and consequences
If a patient ignores a problem such as diabetic foot, the symptoms do not cause him to see a doctor, the risk of serious complications increases significantly. First of all, we are talking about various kinds of infectious problems, where the leading place belongs to gangrenes.On the other hand, there may be a rapid spread of necrosis in the muscles, bone apparatus, subcutaneous fatty tissue. All this, of course, entails in almost all cases amputation of the limbs.
Is it possible to prevent the development of such a pathology as a diabetic foot? Prevention primarily involves maintaining a constant level of glucose. All patients with diabetes, without exception, must constantly monitor their health, comply with the recommendations of doctors for treatment.
In addition, patients should inspect the foot every day, the symptoms even at the earliest stage should alert and become a reason to consult a specialist.
Prevention of diabetic foot also implies knowledge, and most importantly, compliance with the rules of foot care. Experts recommend a daily shower. It is extremely important to wash your feet in a soapy, soft, sponge that does not damage your skin. After taking a shower, feet should be treated with a special softening cream. In order to avoid infection, it is recommended to periodically treat small cracks and wounds on the soles.
People with such a diagnosis is extremely important with particular attention to the choice of casual shoes, it is better to prefer the orthopedic option.
With the thickening of the nail plate due to mycosis (fungal disease), it is recommended to apply a special varnish on the affected surfaces to prevent further spread of the disease.
In this article, we described what constitutes a pathology called a diabetic foot. The symptoms of the disease, described above, should alert everyone and become a reason for contacting a specialist. Otherwise, the likelihood of developing quite serious complications, including full amputation, increases.
We hope that all the information presented here will be really useful for you. Be healthy!