Diabetic foot - Causes, Symptoms and Treatment .MF .
In recent decades all over the world recorded a catastrophic increase in the incidence of diabetes.This trend is fully traceable and in Russia.According to experts, every tenth Russian has implicit or explicit violation of carbohydrate metabolism.The greatest danger in this disease are the consequences of such violations in the form of damage to various organs and systems.Diabetes gradually destroys substantially all cells in the body.And eyes, kidneys, heart and liver, and brain are equally sensitive to an excess of glucose in the blood.As a result of prolonged exposure to large concentrations of blood sugar in diabetic patients develop late complications of the disease.Perhaps one of the most severe complications is the diabetic foot syndrome.
Causes and symptoms of diabetic foot
Diabetic foot - a necrotizing process or gangrene of the foot.Under the diabetic foot syndrome, and also understand the state immediately preceding the development of necrosis, including severe damage to the peripheral ner
More than 5% of all people with diabetes in their lifetime face this serious complication.The greatest risk of developing diabetic foot syndrome in patients with the following conditions:
* severe damage to the nervous
foot tissue * damage of arteries
* foot deformity
* chronic renal failure
* tobacco addiction
The most common syndrome developsin patients with type 2 diabetes in older age groups.
In the occurrence of diabetic foot big role may belong to damage to nerves or blood vessels.Depending on this, diabetic foot are classified as neuropathic and ischemic.Perhaps the development and mixed forms of the syndrome.
On examination of the lower limbs can be expected to determine what underlies the complications - neuropathy or ischemia.In neuropathic form of skin on the foot is dry, there are areas of skin changes in the area of highest pressure during walking, the foot is deformed, pulsation in the arteries preserved, painless ulcer defects, complaints from patients virtually none.In ischemic form (vascular injury), the skin on the foot thinned, cyanotic, pulse is not detected on the arteries, wounds and fissures are located on the fingers, sharply painful.
Of course, only an external examination does not provide complete information about the state of the vessels and nerve tissue.When to see a doctor about diabetic foot syndrome, the patient should be admitted to hospital for examination and treatment.Patients in the hospital assesses all kinds of sensitivity (vibration, temperature, pain), the definition of tendon reflexes, electroneuromyography, x-ray, ultrasound scan of the arteries.After further diagnosis, the patient is prescribed medication based on individual sensitivity.
Treatment of diabetic foot
Treatment of neuropathic form of diabetic foot include:
* normalizing blood sugar
* Software foot rest
* surgical removal of dead tissue in
wounds * antibiotics as pills or injections
* the use of modern dressings
surgical removal of dead tissue in the wounds of diabetic foot
treatment of ischemic form of diabetic foot include:
* normalizing blood sugar and cholesterol
* rejection of
smoking * treatment
hypertension * decrease excessive blood viscosity (aspirin, heparin)
* surgical repair of vascular permeability
Amputation is also a way of treating diabetic foot syndrome.Indications for amputation - is purulent fusion of the bones of the foot, the critical decrease in blood supply to the tissues.
In Russia, most often run high amputation.Operation in the middle or upper thigh level is one of the most common.After these interventions the patient is considered to be invalid.Serve yourself at home, much less fully work becomes extremely difficult.Therefore, in the first place to combat diabetic foot prevention goes.
Prevention of diabetic foot syndrome
treatment of diabetes, nerve and vascular damage is considered to be the best prevention of diabetic foot.Normalization of carbohydrate metabolism is probably the most difficult to reach.Blood sugar and glycated hemoglobin in a patient should not exceed the individual target threshold.Typically, the goal is to fasting sugar 7.5 mmol / l of sugar during the day to 10 mM / liter, glycated hemoglobin is less than 7.5%.
treatment of nervous tissue is held together by a neurologist and an endocrinologist.Traditionally used drugs alpha-lipoic acid (Valium, Thioctacid, Oktolipen), B vitamins (Milgamma, Combilipen, Neyromultivit), physiotherapy (magnetic) and physiotherapy exercises.
vascular treatment is carried out by the endocrinologist and surgeon.The important point is considered quitting smoking and reducing excess levels of blood fats (cholesterol).
In addition, a visit to a specialized office of the diabetic foot in health care and clinical supervision in the community reduces the risk of complications.In large cities are usually organized Diabetes Center, where patients will be able to one day see and diabetologist, and experts in other fields.
important step in the prevention of patients considered training in specialized programs on the basis of the so-called "Schools of diabetes".During sessions with patients and families to discuss in detail the rules of foot care and shoe selection.
Shoes for patients with strain foot should be made individually in orthopedic showrooms.In other cases, shoes bought in retail stores, observing the following rules:
* shoes chosen strictly on the size
* not wear rubber shoes
* heel should not be higher than 4 cm
* Shoes should not be too narrow
* already at the first fittingshoes should be comfortable
In general, all the rules of selection of shoes reduced to the fact that the shoes must not damage or compress the foot and prevent the evaporation of excess moisture.Rubber boots can provoke damage to the foot.They can not be worn for more than 30 minutes at a time, and it is better to opt out of this material.
Rules foot care are divided into two groups: the right thing to do for prevention and can not do in any case.
* You can not wear open shoes, wearing any shoes, "barefoot"
* Do not walk barefoot
* Do not remove calluses on their own with the help of patches, ointments, razors
* can not be used for the care of foot metal andsharp objects (scissors, razors)
* It is impossible to do a pedicure at beauty salons
* No wounds and scratches can not handle alcohol-containing substances (iodine, salicylic alcohol, brilliant green).For these purposes may be used hydrogen peroxide, chlorhexidine, miramistin.
Care Recommendations Foot:
* Before you put on shoes, felt the hand of its inner surface (exactly there lies the insole did not get there in the boot of any small items??)
* Daily evening make warm baths for feetfor 10 minutes
* After the bath legs should be thoroughly dried with a towel
* daily apply the cream with urea or plant extracts on the plantar surface of the foot * daily
carefully inspect the stack, treat cracks, for any suspicious changes - to the doctor.
* Within 5 minutes before bedtime to do light foot massage, a special set of exercises gymnastics
foot during the day exposed to high loads.Our entire weight rests on its surface.Movement when walking rather monotonous.In diabetes, nerve damage leads to the fact that people can not feel the pain of minor injuries, friction burns.These wounds will not heal - for patients with reduced blood flow, trophic tissues.An important factor is the decrease of immunity due to diabetes.Bacteria quickly penetrate the wound and multiply freely in it.As a result of those injuries that without diabetes might pass unnoticed at all, in patients with impaired carbohydrate diabetes sometimes leading to gangrene and amputation.Therefore, diabetics should be very responsible attitude towards the care of the foot, shoe selection, monitoring specialists.Fighting metabolic disorders diabetes (normalization of blood sugar) is certainly the basis of prevention of any complications, including diabetic foot syndrome.
endocrinologist Tsvetkova IG