Diabetic foot syndrome – is a collective term that represents the totality of foot disease in diabetes mellitus. All these diseases are associated with lesions of the skin, soft tissues, bones and joints. They are manifested in the form of venous ulcers, skin-articular changes and necrotic processes. This is due to arise on the background of diabetes and neurological disorders, reduced trunk blood flow in the arteries of the lower limbs of varying severity.
This syndrome occurs in each 8-10th of a patient with diabetes mellitus, and every second is at risk. In diabetes mellitus type II, this syndrome develops in 10 times more frequent than in type I diabetes and may occur at the outset of the disease (and sometimes the first sign of diabetes, which attracts attention). In diabetes mellitus type I syndrome develops this year to 7.10 of the disease.
The reasons that contributes to the diabetic foot.
Direct causes that cause the development of diabetic foot syndrome are the three factors that caused by hyperglycemia:
1) failure of the peripheral nervous system (neuropathy);
2) loss of lower limb arteries (angiopathy), followed by the deterioration of blood flow;
3) adherence to the background of these pathological processes of infection.
Depending on what violations prevail, distinguish several forms of this syndrome:
Nerve damage (neuropathic form), which may be associated with pathology of osteoarticular apparatus or without bone involvement;
The defeat of the vessels (ischemic, form), resulting in reduced blood circulation in the limbs;
Mixed neuroischemic form.
In 85% of the complication occurs in the form of the ulcer.
For neuropathic diabetic foot shape risk factors include the following:
Inadequate compensation for blood sugar levels. The worse is controlled number, the greater is the chance of developing the syndrome and the faster it can occur;
Duration of diabetes. The longer is the disease, the higher is the risk of this complication.
Age. With age, the probability of disease increases.
Excessive alcohol consumption.
The most serious complication of diabetic foot is the development of diabetic gangrene, which contributes to the emergence of the following factors: nonhealing extremity microtrauma, frostbite or a burn, ingrown nails, calloused education, fungal diseases, as well as the severity of angio-and neuropathies.
The clinical picture of diabetic foot syndrome.
Depending on the prevalence of neuropathy or angio-patii in the development of this complication, the clinical picture is different. When there is neuropathy there are two types of clinical manifestations:
Painless form – accompanied by a decrease in pain sensitivity (which is more common and more dangerous, because the wounds and injuries may go unnoticed);
Pain form – manifested by various symptoms:
Tingling, burning, pain, worse at rest.
The skin is dry neuropathic form, in areas of excess pressure formed blisters and painful sores. Pulsation of the arteries in the feet is kept.
Pulsation of the arteries in the feet is lower, or absent.
On the fingertips or the boundary surface of the heel formed sharp painful ulcers. When walking, marked pain in the legs, and therefore produces a characteristic gait, which is called intermittent claudication.
This distinguishes the ischemic form of neuropathy, in which the pain disappeared while walking.
The speed of the initial stage of diabetic foot depends on the degree of compensation of blood sugar levels.
Prophylaxis of diabetic foot syndrome.
Major role in the prevention of this complication is careful monitoring and correction of blood glucose and other metabolic disorders (eg, blood lipids).
Studies have convincingly shown that if blood sugar for several years, is not more than 9 mmol / l, even in the presence of angiopathy and (or) the neuropathy condition is greatly improved – decreases or disappears clinical symptoms, improves wound healing. A very important factor, prevents the development of diabetic foot in patients with diabetes mellitus type II, is the transition to insulin in the absence of the effect of taking tablets of funds. In order to spot the beginning of the diabetic foot, it is imperative to conduct regular inspections by a specialist.
Prophylaxis has primary role in the prevention of amputation. Unfortunately, it neglected and at least half of the patients treatment does not begin on time. It should be noted that the time taken by the vigorous preventive measures can reduce the incidence of amputations in patients up to 90%. Currently, every 30 seconds in the world is lower limb amputations due to diabetes, with a significant number of patients after surgery will know that they have diabetes.
Important role, in addition to normalization of blood glucose, belongs to the timely and adequate correction of other risk factors, as well as an active qualified treatment of ulcers and other defects of the foot.
Every patient with diabetes should know the rules for foot care, and be able to choose and wear shoes and socks.
See Also
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