Diabetic foot – when does amputation end?

Diabetic foot (diabetic foot syndrome; ZSC for short) is a complication of diabetes that occurs in both type 1 and type 2 diabetes. – although more often in the latter group. It applies to even 10-15 percent. diabetics. As a result of nerve damage, diabetics suffer from disturbances and loss of sense of touch, pain, and temperature. The consequence of this condition are numerous injuries. Blood vessels are also damaged. The foot becomes dry, flaky and breaks into blood. Wounds are difficult to heal, ulcers appear. The lesions characteristic of a diabetic foot usually appear on the plantar or dorsal surface of the foot.

This is not only an aesthetic problem. If we don’t react in time, we can lead for irreversible deformation of this part of the body, necrosis and amputation (in Poland, such treatments are often performed).

Unfortunately, changes in the feet are often the first visible sign of diabetes, an alarm signal that prompts us to perform basic tests and visit a doctor.

Diabetic foot syndrome is most commonly diagnosed in people who have persistent high blood sugar levels for a long time as a result of undiagnosed or incorrectly treated diabetes. Constantly elevated blood glucose levels damage the nerves (neuropathy or polyneuropathy) and blood vessels (angiopathy).

Damage to the peripheral nerves is responsible for the lack of pain, for example. A diabetic patient will not experience discomfort as a result of, for example, wearing too tight shoes. He will not feel when his foot comes onto a sharp object. He will also not notice burns immediately due to disturbed temperature perception. He will notice these “inconveniences” only when there is a mark on the skin in the form of a blister or a bleeding wound. This carries the risk of developing a serious infection.

Too much glucose in the blood also damages blood vessels. Over time, they become less and less flexible and prone to atherosclerotic lesions. The lower limbs become insufficiently oxygenated and supplied with blood. There is pain, wounds are more difficult to heal, and the tissues are in danger of dying.

There are three types of diabetic foot: diabetic ischemic foot, diabetic neuropathic foot and diabetic ischemic-neuropathic foot (mixed type).

Ischemic and neuropathic changes may develop simultaneously. However, one type dominates most often. Differentiating diagnosis is necessary, as the treatment of each type of diabetic foot is different.

Symptoms that may appear in diabetic foot syndrome include:

  • disturbances in the sense of touch, pain, temperature,
  • numbness, tingling, burning, stinging,
  • pain when walking and resting,
  • dry and thin skin,
  • peeling, keratosis of the skin,
  • muscle spasms that get worse at night
  • cracks, e.g. on the heels,
  • deformed nails,
  • swelling,
  • hard to heal wounds and ulcers,
  • increased susceptibility to infections,
  • muscle weakness and muscle atrophy,
  • deformities (valgus, hammer-shaped, flatfoot toes).

Treating a diabetic foot is difficult and it is a long and costly process. Specialists from various fields of medicine should participate in it. In addition to a diabetologist who deals with the diagnosis, therapy and prevention of diabetes, the care of a dermatologist, podiatrist, vascular surgeon, orthopedist or physiotherapist is necessary. It is worth knowing that there are also specialized units that deal with the treatment of the diabetic foot syndrome.

First of all, it is necessary to control the metabolic rate of diabetes – adherence to a diet and treatment that will lead to a reduction in blood glucose levels. Also, infections and ulcers formed are treated with antibiotics administered orally or intravenously. Wounds require the use of appropriate dressings. In many cases, surgical debridement is necessary.

The affected limb should also be relieved. This is where orthopedic insoles, foot immobilization shoes, orthopedic shoes, a plaster cast, elbow crutches or a wheelchair will help.

Education of a patient with a diabetic foot is of great importance.

Hygiene is the most important thing. The feet should be washed twice a day with soap, in lukewarm, not hot water. You must not wet your feet longer than it takes to wash them. Then you need to dry them carefully, along with the spaces between the fingers.

After washing, the skin of the feet should be lubricated. Preparations containing paraffin, which retains water in the skin (in diabetes it is dry), will be a good choice. Creams with urea will also help moisturize the feet, and those with vitamin A + E will nourish the epidermis. The addition of silver, which has antibacterial properties, will speed up wound healing and prevent infections.

It is important not to go barefoot – this way you can avoid stepping on sharp objects. Each scratch, abrasion, wounds, cuts or ulcers should not be underestimated – go to a doctor with them. Sharp heel abrasives are not recommended.

Attention is also paid to the nails – they should be cut straight so that they do not grow ingrown, but also not too short. You have to omit skins.

In addition, people with diabetic foot should wear comfortable, soft shoes and change socks (wool or cotton) daily. Do not warm your feet with an electric pillow or hot water bottle.

Also read:

High blood sugar – not only in diabetes

How does diabetes start? The first symptoms

Dishes for diabetics

About Peter Wilson

In love with technology, with an eye towards smartphones, he does not disdain any activity linked to the Nerd world. TV series, movies, manga, anime, and comics (Marvel addicted) are the order of the day.

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