“Originally, it was just that my foot accidentally kicked a chair and my toe was bruised. How did I know that my toe became darker and darker later on. The doctor said that I needed to cut off the toe. However, after cutting off the toe, the wound still did not heal, and I had to clean the sore again. The doctor said that if it doesn’t get better this time, he may have to cut his calf!” This is a common problem for diabetic patients, also known as “diabetic foot”. Every year, on average, 1 in 100 diabetic patients suffer from severe diabetes. The foot is hospitalized, and the amputation rate is as high as 30%, which may lead to death; what exactly is diabetic foot? What complications should we pay special attention to? This article teaches you how to prevent and screen for it.

November 14th every year is Diabetes Day. According to statistics from the International Diabetes Federation (IDF) in 2021, as many as 537 million of the world’s 7.9 billion people suffer from diabetes.

The situation at home is not optimistic either, Our data shows that more 4.3 million people in the UK live with diabetes. Additionally, 850,000 people could be living with diabetes who are yet to be diagnosed. These registration figures for 2021-22 are up by 148,591 from 2020 -2021.

What is diabetic foot?

“Diabetic foot” is a common problem for diabetic patients. If diabetic patients do not control their blood sugar well, they will develop vascular disease. If the blood vessels are not healthy, they will not be able to supply enough nutrients to the nerves, which will easily lead to neuropathy, especially in the toes and fingers. Symptoms usually start in the toes. It begins to appear and slowly extends upward, and is more severe on the lower limbs than on the upper limbs. Because of neuropathy, the skin is prone to dryness and cracking, and the patient’s sense of pain becomes dull. Patients are prone to bruises or lacerations without realizing it, which can lead to secondary bacterial infections. Coupled with poor blood circulation, tissue hypoxia, and loss of white blood cells. Methods to sterilize, so it is easy to form diabetic foot ulcers.

Why do diabetic feet occur?

Excessive blood sugar can cause inflammation and damage to blood vessel walls, triggering platelet aggregation and leading to atherosclerosis. The diameter of blood vessels becomes increasingly narrow, which can easily cause arterial obstruction in the lower limbs. When a foot is injured, the wound needs good blood circulation to repair the tissue. If the arteries of the lower limbs are narrowed or blocked and blood circulation is poor, the wound will be difficult to repair, and such a small wound may turn into a foot ulcer. If you take superficial wounds lightly and delay medical treatment or follow folk remedies, it may cause the wound to deteriorate to a deeper level, and even cause cellulitis due to bacterial infection, trigger systemic sepsis, and lead to multiple organ failure.

Why is diabetic foot screening important?

According to 2009 database statistics, on average one in 100 diabetic patients is hospitalized for severe diabetic foot every year, and the amputation rate is as high as 30%; once a diabetic foot ulcer occurs, the average life expectancy is only 6.1 years, and the average life expectancy of amputees is Only 3.3 years; therefore, foot screening and care is particularly important for diabetic patients.

What are the causes of diabetic foot lesions?

If a diabetic patient has poor blood sugar control for a long time, the body’s organs will be like soaking in sugar water. Over time, diabetes will destroy the blood vessels throughout the body and cause vascular disease. If the blood vessels are not healthy and cannot supply enough nutrients to the nerves, it will easily lead to neuropathy; causing diabetes. The three major factors causing foot lesions in patients are:

1. Lower extremity vascular disease
   
2. Neuropathy
   
3. local infection

Generally, the wounds of non-diabetic patients can recover in 1-2 weeks with proper care. In contrast, diabetic patients are prone to foot ulcers, which can lead to toe or limb amputation in severe cases.

Foot care tips for diabetics

With or without foot problems, people with diabetes

1. You should self-examine your feet every day, including between toes, sides, soles, etc.
   
2. If you have thick skin or thick calluses, you can use a pumice stone to gently remove the thick skin after taking a bath or soaking your feet in warm water.
   
3. To prevent dry skin, you can apply alcohol-free lotion, but it should not be applied between the toes to avoid causing athlete’s foot.

People with diabetes should be screened for neuropathy

According to the recommendations of the American Diabetes Association, all patients with diabetes should be screened for peripheral neuropathy to detect neuropathy early and avoid continued worsening of symptoms. The following are recommended times for peripheral neuropathy screening:

1. People with type 2 diabetes: should be screened for neuropathy when diagnosed and at least once a year thereafter
   
2. Type 1 diabetes patients: Be screened for neuropathy starting 5 years after diagnosis and at least once a year thereafter
   

6 major complications that patients with diabetes should pay attention to

Diabetic patients with poor blood sugar control are prone to subsequent complications including:

1. chronic kidney disease
   
2. Retinopathy
   
3. Neuropathy
   
4. coronary heart disease
   
5. stroke
   
6. diabetic foot

It is recommended that diabetic patients master the A to G principles and control their diabetes well to avoid serious complications:

A (HbA1C) Glycated hemoglobin

B (blood pressure) blood pressure

C (LDLC) low-density lipoprotein cholesterol

D (drug) Take medicine on time as directed by your doctor

E (eye) Fundus examination at least once a year

F (foot) Foot examination at least once a year

G (eGFR) Urine microalbumin test at least once a year to regularly monitor kidney function

Do a good job in diabetes management based on the above indicators. If complications have occurred, please do not be discouraged. Cooperate with your attending physician and receive timely treatment to maintain a good quality of life.
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