Diabetic foot: causes, symptoms, treatment

This phenomenon includes a large number of changes in the skin, muscles, bones, arteries, blood vessels. They occur under the influence of too much sugar in the blood. It is he who has a negative effect on cells and tissues, resulting in pathological changes. Statistical data show that about 10% of diabetics face this problem. Half of the patients are at risk. A diabetic foot develops if sugar is elevated for too long. Therefore, it is necessary to monitor its level and try to regulate it. Otherwise, the lower limbs will suffer greatly, and ulcers and even gangrene will develop as a result of infection. In especially dire cases, leg amputation is required. The worst thing is that even after surgery, there is a high risk of death. This is due to postoperative complications, which develop in about half of the cases.

Any, even the smallest deformity of the foot, can lead to a serious complication. Therefore, if a diabetic notices changes in the legs, then you should quickly contact a specialist.

The main reasons for the development of the problem

There are several basic prerequisites due to which a complication can develop. These include:

• Lower limb neuropathy. In a more understandable language, the nerves of the feet are damaged, as a result of which the diabetic does not feel well the effects on his legs. For example, if a person walks in tight shoes, and she rubs him, then he may not notice it in time, because he practically does not feel anything. Calluses and other injuries on the legs are detected only when they become very noticeable; 
• Poor blood circulation. Veins and blood vessels are affected by diabetes. As a result, blood circulation in the legs is severely impaired, which leads to too slow healing of the resulting injuries; 
• Injuries. Diabetics need to constantly protect themselves from traumatic influences. Even the smallest scratch can lead to a serious complication. In addition, due to a decrease in sensitivity, the patient sometimes does not notice the dislocation of the joint; 
• Fungus. Infections contribute to the development of a diabetic foot. If symptoms of a fungal disease occur, then it must be immediately eliminated with the help of effective drugs; 
• Ingrown nail. If such a problem is not noticed and eliminated in time, then it can cause infection of the toe, and then the entire foot. Nails usually grow in if they are not neatly trimmed with scissors. Use a file to get a rounded edge. This will avoid ingrowth. 

Even the smallest wound can lead to the development of a diabetic foot, due to which the infection spreads. Therefore, you must very carefully monitor the condition of your feet, do not wear too tight shoes and avoid injury.

Often the problem arises from the appearance of commonplace calluses . This is especially true of situations when the patient removes the callus, and an open wound remains in its place. It can quickly fester, which will lead to the spread of infection. Comfortable shoes should be worn to prevent calluses. The best option is orthopedic products, which are currently presented in a wide range. Blisters are another cause of diabetic foot development. If the shoes rub your feet, bubbles with liquid inside may appear on the skin. You cannot pierce them, otherwise the infection will spread quickly. It is necessary to contact a specialist to recommend gentle treatment methods. Most often, medical dressings are used, which make it possible to do without mechanical action on the blister. Warts are another problem that can be dangerous for a diabetic. To prevent such a skin disease from manifesting itself, you must try to keep your feet dry and clean.     

If unpleasant changes appear on a diabetic’s leg, be it corns or warts, it is necessary to immediately take measures to eliminate them.

It is not recommended to try to cope with the problem on your own; it can lead to even more serious problems. You need to contact a specialist.

Risk group

It is clear that almost all diabetics are at risk, but there are several factors that greatly increase the likelihood of developing a complication. The level of risk increases several times in the following situations:

• The patient often feels tingling or numbness in the foot;
• A history of vascular pathology;
• A person wears shoes that are too uncomfortable, tight, which can lead to blisters;
• There are congenital deformities of the foot, for example, flat feet;
• The patient has bad habits, smokes or drinks alcohol.

From all of the above, it can be concluded that the risk of developing diabetic foot can be reduced. To do this, you need to constantly monitor your feet, wear only good shoes that will not chafe. It is also worth giving up bad habits, especially since they have a negative effect on the entire body, and not just on the legs.

Diabetic foot symptoms

The main danger of a diabetic foot is that often the patient does not feel any pain or discomfort. This is due to the death of nerve endings. If the complication is not diagnosed in time, then it can develop into a serious stage, and the problem can only be solved by amputation. Therefore, you need to carefully monitor your condition. There are several characteristic symptoms that indicate the development of the problem. This includes:

• Dryness of the skin;
• Cracks;
• Change in the color of the foot;
• Swelling;
• The appearance of small ulcers;
• Feet temperature rise.

Sometimes a symptom such as lameness occurs. Therefore, if a person with diabetes begins to limp, then this should cause concern.

When contacting a specialist, he will assess the condition of the foot and identify signs that may indicate the development of a complication. So, the doctor always looks at the presence of redness. If they are localized around the wound, then this indicates the onset of the inflammatory process, which can be very dangerous. Hot parts of the foot can also speak of inflammation. And due to circulatory disorders, edema often occurs.

Varieties of diabetic foot

There are several types of diabetic feet. They are classified according to the type of changes that occur in the patient’s body. The following types of pathology are distinguished:

• Ischemic diabetic foot. It develops due to the fact that blood circulation in the legs is disturbed. The result is a discoloration of the skin, as well as the occurrence of edema. While walking, the diabetic experiences severe painful sensations. Ulcers are usually located near the toes. They have jagged edges. If you touch the ulcer, then the patient experiences pain; 
• Neuropathic diabetic foot. It develops due to a disorder in the nervous system. A person practically does not feel anything, the foot loses sensitivity. The skin becomes dry and cracked. Ulcers are located all over the sole. They are not painful to touch and have smooth edges. The skin of the foot takes on a red tint, it feels hot to the touch; 
• Mixed diabetic foot ( neuroischemic ). In this case, pathological changes concern both blood circulation and nerve endings. 

The most common form is neuropathic . It is diagnosed in about 70% of patients. The ischemic form occurs in only 10% of patients. The mixed form is also rare, but it is the most dangerous.

Development stages

Speaking about the causes, symptoms, treatment of diabetic foot, it is important to know about the sequence of its development. There are several stages, and as the transition from one to the other, new unpleasant symptoms appear. So, the following stages of the diabetic foot are distinguished:

• Zero. Deformation of the foot occurs on it, corns and other neoplasms appear; 
• First. Ulcers affect only the upper skin. The infection does not penetrate deeply yet; 
• Second. The pathological process spreads deeper, affects not only the skin, but also the tissues located under it. The infection affects muscles, tendons, adipose tissue; 
• Third. The ulcerative process reaches the bones; 
• Fourth. Gangrene occurs; 
• Fifth. Gangrene spreads over imposing areas. Not only the foot is affected, but also the lower leg. 

You should try to identify problems as early as possible. Until the ulcerative process has penetrated deeply, it is possible to do without amputation. Otherwise, only removing part of the leg will help.

Diagnostic process

To diagnose human pathology, they are usually referred to an endocrinologist, neuropathologist, surgeon. Diagnostic measures begin with anamnesis collection. The specialist finds out whether there have been injuries of the lower extremities in the past, how long the patient has been suffering from the disease, asks other important questions. Next, the doctor examines the foot, visually assessing it, determining the presence of ulcers and other problems. Also, the specialist examines the shoes, draws conclusions about their convenience. For diagnostics, laboratory research methods are also needed, which make it possible to draw up the most complete picture. If there is a wound on the foot, then the specialist sends its contents for analysis. It is also necessary to conduct a blood test, including for glucose levels. Instrumental methods are also used for the survey. These include:

• X-ray;
• Ultrasound;
• Doppler ultrasonography.

These methods allow you to assess the internal state of the foot. With the help of X-rays, the specialist draws conclusions about the state of the bones. Ultrasound examination is necessary in order to assess how much the pathology has affected the vessels. With Doppler sonography, the specialist can see the veins and arteries.

Diabetic foot treatment

In case of detection of diabetic foot syndrome, it is necessary to take timely treatment. His technique depends on the stage of the disease. If the lesions of the foot are insignificant, then conservative treatment is prescribed. If the process is already irreversible, then only surgical intervention will help. Conservative treatment includes the following actions:

• Normalization of blood sugar levels;
• Taking antibiotics, the type of which is chosen depending on the results of bacteriological examination of the wound;
• Taking pain medications;
• Taking medications that improve blood circulation;
• Local application of agents that disinfect the surface and destroy harmful microorganisms.

If surgical treatment is necessary, then depending on the condition of the leg, one of the processes is selected. These are the following operations:

• Angioplasty. This method allows you to remove areas of gangrene while preserving the limb;
• Vascular shunting;
• Plastic skin;
• Amputation.

Specialists always try to prevent amputation, but to preserve the foot. But if other methods cannot cope with the problem, then you have to take away the limb.

Prevention

In order to prevent the progression of the disease, it is important to always remember about preventive measures.

This includes monitoring blood sugar levels, maintaining a diet and drug regimens, and wearing comfortable shoes. You also need to monitor the h