Diabetic foot is one of the main complications of diabetes that presents itself when the person has diabetic neuropathy, because the person is not sick when a lesion, ulcers and other lesions occur on the feet. Due to diabetes, these diseases take longer to heal from normal, as they can cause recurrent infections, increasing the risk of amputation of the foot. Learn more about diabetic neuropathy.
This type of complication is more common when blood sugar levels are not controlled, therefore, one of the best ways to prevent the development of diabetic foot is to follow the doctor’s instructions for the treatment of diabetes.
In addition, to avoid the development of diabetic foot, it is recommended to carry out a regular check of the feet, which can be carried out at home, but it should also be checked by the doctor in the office. In case the person has a diabetic foot condition, it is important to perform cures at the health center or at the hospital, so how to use comfortable shoes and maintain proper foot hygiene.
The symptoms that commonly manifest a person with diabetic pie are:
- Pain or loss of sensitivity in the pie;
- Bad odor in the lower extremity;
- Enrojecimiento del pie;
- Exit of pus through the heridas;
- Changes in skin temperature.
It is important that the person remains attentive to these changes, since the manifestation of some of these symptoms is a reason to consult a doctor and that he performs a detailed evaluation of the foot in search of other changes to be able to start the proper treatment and avoid it. progress of this change.
How is the diagnosis performed?
The diagnosis of diabetic foot is performed by a general physician, internist, endocrinologist or vascular surgeon and is based on the manifestation of signs and symptoms presented in the lower extremity. However, the physician can use clinical instruments and/or request other studies to confirm the diagnosis, such as the Rydel-Seiffer Diapason, which is used for the production and detection of a vibration that the patient must perceive; This is like an Eco-Doppler exam, in which an ultrasound is applied to assess the blood flow in the arteries and large veins in the arms and legs.
Risk factors for developing diabetic pie
People who have a higher probability of developing a diabetic condition are those who have poor control of the illness and do not have regular medical care for an evaluation.
Among the main risk factors that a person has for the presentation of diabetic foot are: having a diagnosis of diabetes since at least 10 years, history of ulcers or amputation of a lower limb, alterations in the nails of the feet, presence of diabetic neuropathy, in addition to that it is more frequent than it is present in men.
Rating scales for diabetic pie
Currently, there are scales used to know the stage of affectation of diabetic foot, the Wagner scale and the University of Texas scale. The Wagner classification has begun to be replaced by the one from Texas, the latter being the one that has the greatest current acceptance among the medical community.
- Grade 0: Pie with high risk, without inheritance or ulcer;
- Grade I: Superficial ulcer;
- Grade II: Deep ulcer, compromise of tendons;
- Grade III: Ulcer with bone compromise;
- Grade IV: Localized gangrene;
- Grade V: Gangrene del pie.
This scale classifies the lesions based on the depth and presence of infection or ischemia in the foot, as follows:
|Grade 0||Grade 1||Grade 2||Grade 3|
|Stadium A||Completely epithelialized pre or post ulcerative lesions||Superficial herit that does not involve the tendon, encapsulates the bone.||Inherit penetrating the tendon or capsule||Inherit penetrating the hueso or articulation|
|D Stadium||infection and ischemia||infection and ischemia||infection and ischemia||infection and ischemia|
It is important that the doctor classifies the lesions of the diabetic foot, as through this it is possible to evaluate the medical treatment and the care that the person must have and even consider it a possible amputation of the foot.
How is the treatment performed?
The treatment will depend on the signs and symptoms presented by the person, in addition to the stage that the doctor has identified to start the therapeutic plan. Those persons with the presence of a deep ulcer, the doctor can indicate an intensive treatment that can be carried out in the hospital, requiring that the person remains hospitalized.
In addition, among the different types of treatment, the protection of ulcers through a temporal footwear is included; revascularization in person with signs or symptoms of ischemia; curation and debridement of necrotic tissue, use of antibiotics; good blood glucose control and frequent debridement with a scalpel, if necessary. In the most severe cases, the doctor may indicate the amputation of the foot or the infected leg.
Diabetic foot care
The main care that a person must have with a person affected by diabetes are:
- cut the nails, in a straight line looking for the edges of the peaks that stand out;
- daily review of los pies, looking for blisters, fungi in nails, calluses, changes in color or temperature and dry skin data;
- Washed and dried correctly, all days with a neutral hand and with special care in the areas between the fingers;
- use of calcetines, that in tengan seams, ni resorts and sean de algodón;
Likewise, the application of creams and talc should be considered in case of sweating, the cream must not contain perfume or menthol, as it can irritate the skin. It is important to take these precautions and carry them out every day to avoid infections and complications.
The type of shoes that should be used in case of suffering from diabetic foot should have specific characteristics to avoid complications and promote the health of the extremities of the person.
The footwear must be made of natural material, preferably made of bovine leather, without having seams that may have contact with the foot, the sole must be made of flexible and wide gum, in addition to being non-slip. After buying them, the person should try to use the new shoes in periods of 30 minutes daily until they get used to them.
Main complications of diabetic pie
The most frequent complications of diabetic foot are lower limb infection, pain or numbness in the area and ischemia. The main complication, and the most serious of the diabetic foot, is the amputation of the lower extremity, and the surgical cut, is the sole of the foot or the pierna. This is due to the presence of ischemia or the development of an infection that causes the treatments to be unsuccessful.
In addition, due to the fact that diabetic neuropathy is an advanced stage of diabetes mellitus, the person may present eye problems such as blindness and even changes in the kidneys that lead to treatment with dialysis or hemodialysis after the surgical intervention. The most common infection of the diabetic foot is osteomielitis, which can lead to the amputation of the skin before a bad control of the illness. Learn more about the symptoms and treatment of osteomielitis.
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