Content Sources:
1. Guidelines for the diagnosis and treatment of diabetic foot. Chinese Diabetes Society, Chinese Journal of Diabetes.
2. Research Progress on Comprehensive Treatment of Diabetic Foot. Li Ming et al., Chinese Journal of Diabetes.
3. Research Progress on Pathophysiological Mechanisms of Diabetic Foot. Zhao Yang et al., International Journal of Diabetes.
Diabetes is one of the diseases we are all afraid of, in addition to the trouble caused by the disease itself, the biggest problem is actually a series of complications it induces, the most typical of which is diabetic foot.
1. Why does diabetes cause diabetic foot?
Diabetic foot is a serious complication of advanced diabetes that manifests as foot infections, ulcers, and destruction of deep tissues, and in severe cases, amputation. The pathogenesis is complex, mainly including the following three aspects:
1. Neuropathy: Long-term poor blood glucose control can lead to systemic small vessel lesions, which in turn affect the blood supply to nerve fibers and cause peripheral neuropathy. This peripheral neuropathy leads to decreased sensation in the feet, and patients often do not feel the trauma and pressure on the feet in time, which leads to wounds and ulcers. At the same time, autonomic neuropathy can also affect the function of the sweat glands in the feet, resulting in dry and cracked skin that is more susceptible to bacterial attack.
2. Vascular disease: The persistence of hyperglycemic state in diabetic patients can cause endothelial cell dysfunction, leading to microangiopathy, which in turn affects the blood circulation of the foot, reduces the blood supply to the skin, muscles and other tissues of the foot, delays wound healing, and makes the bacterial infection more serious. At the same time, diabetic patients may also have macrovascular lesions, such as arteriosclerosis, which further aggravate blood circulation disorders.
3. Infection: Diabetic feet are very prone to various bacterial, fungal and other microbial infections due to decreased sensation and insufficient blood supply to the feet caused by neuropathy and vascular lesions. Infection not only accelerates the process of tissue destruction, but also further affects blood sugar control, creating a vicious cycle.
Diabetic patients have a relatively weak immune function and reduced resistance to infection, and once an infection occurs in the foot, it is often difficult to control, which can lead to long-term non-healing ulcers, or severe infection and may have to take measures such as amputation.
2. What are the hazards of diabetic foot?
1. Infection and ulcer formation
Diabetic patients are susceptible to bacterial or fungal attacks due to long-term increases in blood sugar levels, which makes the skin less resistant. Once a foot injury is made, even a small wound can be undetectable and lead to infection. In a hyperglycemic environment, bacteria tend to multiply, making the wound more severe and forming ulcers.
Not only do these ulcers heal slowly, but they can also progress to more serious infections such as cellulitis and osteomyelitis. If left untreated, these infections can seriously affect the quality of life and are costly to treat.
2. Disorders of blood circulation in the lower limbs
Long-term poor blood sugar control in diabetes can cause damage to microvessels and large blood vessels, resulting in blood circulation disorders in the lower limbs. Circulatory disorders not only directly affect the nutrient supply to the legs and feet, increasing the risk of limb necrosis, but also cause patients to experience severe symptoms such as intermittent claudication.
In addition, impaired blood circulation can make it difficult for minor wounds in the foot to heal, and even tissue necrosis due to severe ischemia. In the event of severe infection and necrosis, amputation may be required, which is undoubtedly a great physical and psychological blow to the patient.
3. Decreased sensation due to neuropathy
Diabetic neuropathy is another key factor in diabetic foot formation. Long-term hyperglycemia can damage peripheral nerves, resulting in decreased sensation, and it is difficult for patients to feel pain in the feet, temperature changes, etc. This means that in the event of an injury or a foreign body penetration, the patient may go unnoticed and miss out on the best time for treatment.
In addition, neuropathy can also lead to abnormal foot morphology, which in turn increases abnormal pressure points, causing the skin of the foot to harden and dehiscence, forming chronic wounds and providing a pathway for infection.
3. How to prevent the occurrence of diabetic foot
1. Control blood sugar levels
Controlling blood sugar levels is one of the most effective ways to prevent the development of diabetic foot. High blood sugar levels caused by diabetes can damage the body's nerves and blood vessels, slowing blood circulation, making the feet more susceptible to infections and injuries. With strict dietary management, regular exercise, regular medication, or the use of insulin, patients can effectively control their blood sugar levels, thereby reducing the risk of nerve damage and circulation problems.
2. Check and care for your feet regularly
Because diabetes can cause damage to the sensory nerves, this means that patients may not be able to feel small wounds or pain in their feet. These small wounds, if left undetected and treated, can quickly develop into serious infections. Therefore, regular foot check-ups are essential to prevent diabetic foot.
Patients should examine their feet daily to look for any abnormalities, including: scratches, abrasions, blisters, erythema, and changes in the temperature of the feet. In addition to this, it is also important to keep your feet clean and dry, cut your nails short, and avoid exposing your feet to extreme heat or cold.
3. Wear appropriate shoes and socks
Wearing the right shoes and socks can help reduce pressure on your feet and reduce the risk of chafing and injury. Diabetics should pay attention to the following when choosing shoes:
Choose well-fitting shoes and avoid shoes that are too tight or too wide, which can increase the risk of bruising or pressure ulcers. Choose shoes that are supportive and cushioning to help distribute pressure on the soles of your feet. Try to choose shoes with no inseams or soft interiors to reduce the possibility of friction and irritation. Wear socks designed for people with diabetes, which are often seamless and made of soft material to reduce friction and provide better ventilation.
Wearing proper footwear and socks is a simple but very effective way to prevent diabetic foot disease. In addition, if the patient already has a foot problem, they should seek the help of a specialized diabetic foot disease doctor, who may recommend the use of special footwear or orthotic appliances to protect the foot.
In summary, the prevention of diabetic foot requires a multifaceted approach. Good blood sugar levels are well controlled, which can effectively reduce the damage to nerves and blood vessels caused by diabetes. Secondly, regular foot check-ups and care can detect problems in time and take steps to prevent small problems from turning into major problems.
Finally, wearing the right shoes and socks can go a long way in reducing external injuries to your feet. Patients should take individualized preventive measures based on their specific situation, combined with their doctor's recommendations, to minimize the risk of diabetic foot.