Explore strategies for early identification and prevention of diabetic foot

Diabetic foot, as a serious complication of diabetes, seriously affects the quality of life and health of diabetic patients. With the increasing prevalence of diabetes year by year, the incidence of diabetic foot has also shown an increasing trend. Therefore, it is very important for diabetic patients to understand the early identification and prevention strategies of diabetic foot.

1. Definition and pathogenesis of diabetic foot

Diabetic foot is a serious complication of diabetic patients that causes distal neuropathy and vascular disease in the lower limbs due to long-term hyperglycemia, which in turn causes foot infection, ulcers and deep tissue damage. This complication not only affects the quality of life of patients, but is also the main cause of amputation and disability. Its pathogenesis mainly includes decreased or absent foot sensation caused by neuropathy, insufficient blood supply to the feet caused by vascular disease, and immune dysfunction that makes the body more susceptible to infection.

2. Early identification of diabetic foot

1. Early detection of diabetic foot

High-risk diabetic foot is the early stage of diabetic foot, which is mainly manifested by severe peripheral neuropathy and/or peripheral vascular disease in the feet of diabetic patients, or accompanied by foot deformity. Patients who have not yet ruptured to form diabetic foot or have healed diabetic foot in the past are all high-risk diabetic foot. Early intervention for high-risk feet can prevent about 50% of diabetic foot or amputation. In addition, when observing the feet, pay special attention to whether calluses (commonly known as calluses) are formed. If calluses are found, go to the hospital in time to seek help from professional doctors to trim and treat the calluses.

2. Check foot sensation

Neuropathy is a common cause of diabetic foot, which can cause patients to lose or lose sensation in their feet. To check the sensation in your feet, you can use a cotton ball or a thin thread to gently touch the skin of your feet. If the sensation is reduced or lost, you should see a doctor immediately. Because the feet that lose sensation are more vulnerable to injury, and patients often fail to discover and treat it in time, which increases the risk of infection.

3. Observe the color of the feet

Pay attention to check whether the color of the foot skin is uniform, and whether there is any abnormality such as paleness or cyanosis. These abnormal colors may be a manifestation of vascular disease. When blood vessels are damaged, blood circulation will be affected, causing the color of the foot skin to change. Therefore, if you find that the color of your feet is abnormal, you should see a doctor as soon as possible so that vascular diseases can be discovered and treated in time.

4. Check foot temperature

Use a thermometer or touch the skin of your feet to check if there is any abnormal temperature. If the temperature of your feet is too low or too high, it may be a sign of blood circulation disorder. Poor blood circulation can cause hypoxia and malnutrition in the foot tissues, leading to ulcers and infections. Therefore, if you find that the temperature of your feet is abnormal, you should seek medical attention in time so that appropriate treatment measures can be taken.

5. Check for foot edema

Observe your feet for swelling, especially in the ankles. Swelling may be caused by heart failure or venous reflux disorders in the lower extremities. These diseases affect blood circulation and lymphatic drainage in the feet, increasing the risk of infection. Therefore, if you find swelling in your feet, you should seek medical attention in time to identify the cause and treat it.

6. Pay attention to foot pain

Diabetic patients should seek medical attention immediately if they experience abnormal conditions such as pain or burning sensation in the feet. This may be a manifestation of neuropathy or infection. Neuropathy can cause abnormal sensation and pain in the feet, while infection can cause symptoms such as redness, swelling, and pain. If not treated promptly, these symptoms can worsen and lead to serious consequences such as foot ulcers and gangrene. Therefore, if you find abnormal conditions such as foot pain, you should seek medical attention immediately for examination and treatment.

3. Prevention strategies for diabetic foot

1. Control the three highs

Prevention of diabetic foot should start with controlling the three highs, namely high blood sugar, high blood lipids and high blood pressure. High blood sugar is the main cause of diabetic foot. Long-term high blood sugar can damage blood vessels and nerves, leading to poor blood circulation in the feet, and prone to ulcers and infections. Therefore, diabetic patients need to monitor blood sugar regularly, take medication and adjust their diet according to the doctor's advice, and keep blood sugar within the normal range. At the same time, high blood lipids and high blood pressure will also increase the risk of diabetic foot, so they also need to be actively controlled.

2. Quit smoking

Smoking is extremely harmful to the health of diabetic patients. It not only causes pancreatic vasoconstriction and affects pancreatic islet function, but also promotes lower limb vasoconstriction and affects blood supply to the feet. Long-term diabetic patients who smoke are more likely to develop diabetic foot, so they must resolutely quit smoking. Quitting smoking can significantly improve the health of diabetic patients and reduce the risk of diabetic foot.

3. Foot protection

Keeping feet clean is one of the important measures to prevent diabetic foot. Diabetic patients should use warm water (about 37°C) to wash their feet every day, and avoid using overheated water to avoid burns. After washing, wipe the feet dry with a clean, soft towel to avoid moisture and fungal infection. In addition, diabetic patients should also pay attention to keeping their skin dry and avoid wearing damp shoes and socks for a long time to avoid skin inflammation and ulcers.

4. Avoid local high temperature

Diabetic patients should avoid prolonged exposure to high temperatures, such as soaking feet in hot water or sitting by a fire. These behaviors can cause blood vessels in the feet to dilate, increasing the risk of foot injuries. At the same time, diabetic patients should also be especially careful when using heating devices such as hot water bottles and electric blankets to avoid scalding their feet.

5. Choose the right shoes and socks

Diabetics need to pay special attention to their clothing to avoid foot damage. It is crucial to choose the right footwear and shoes. It is recommended to choose socks with good breathability such as cotton or wool, and avoid synthetic materials or chemical fiber socks. For shoes, you should choose loose, comfortable and breathable styles, and make sure that the length of the shoes exceeds the toes by about 1.25cm to 1.5cm, the width matches the widest part of the foot, and the height fits the height of the instep.

6. Check regularly

Developing the habit of checking your feet regularly is one of the important measures to prevent diabetic foot. Diabetic patients should check their feet every day for redness, swelling, damage, infection, etc. If there are any abnormalities, they should seek medical treatment in time. In addition, they should go to the hospital regularly for foot examination and evaluation, ABI and nerve sensory examination, to detect and deal with foot problems in time.

7. Raise awareness of diabetic foot

Diabetic patients should understand the hazards and preventive measures of diabetic foot and strengthen their awareness of foot health care. They can improve their health literacy and knowledge by participating in diabetes education courses, reading relevant books and materials, etc.

8. Regular follow-up

Diabetic patients should follow up with their doctors regularly, keep in touch with their doctors, and keep up to date with their condition and treatment plans. During the follow-up process, the doctor will adjust the treatment plan according to the patient's specific situation and provide personalized advice and guidance. Through regular follow-up and timely adjustment of the treatment plan, the progression of diabetes can be effectively controlled and the risk of diabetic foot can be reduced.

IV. Conclusion

In summary, diabetic patients should regularly check their feet, pay attention to foot hygiene and protection, and strictly control blood sugar to prevent the occurrence of diabetic foot. At the same time, if any foot problems are found, they should seek medical attention and receive regular treatment.

He Caihong

Author profile: Wuchuan People's Hospital, Department: Endocrinology Department, Title: Associate Chief Physician

Member of the Wound Repair Professional Committee of the Guangdong Society of Organ Medicine and Technology, member of the Youth Committee of the Prevention and Treatment of Endocrine and Metabolic Diseases of the Guangdong Preventive Medicine Association, has been engaged in clinical work in internal medicine for more than 10 years. Since 2019, he has undertaken 2 scientific and technological projects in Zhanjiang City. In the past 5 years, he has published 4 medical papers in national and provincial medical journals. Expertise: treatment of various types of diabetes, acute and chronic complications of diabetes, diabetic foot, diabetic combined with wounds, intensive treatment of type 2 diabetes, thyroid-related diseases, osteoporosis, diagnosis and treatment of endocrine hypertension, diagnosis and treatment of obesity.