Prevention and daily care of diabetic foot

Diabetic foot is a common complication of diabetes. It is caused by macrovascular disease, insufficient blood supply to the lower limbs, microvascular disease, and neuropathy in diabetic patients, which leads to lesions of the foot blood vessels and nerves distal to the ankle joint, and then foot ulcers. If further complicated with infection, diabetic foot gangrene will occur, leading to disability or even death. The occurrence of diabetic foot is related to factors such as the course of diabetes and blood sugar control.

Symptoms of diabetic foot

In the early stage, patients only experience itching, dryness, anhidrosis or pigmentation of the foot skin. However, as the course of the disease prolongs, the nervous system is damaged, leading to abnormal sensation in the extremities, such as dullness and numbness. When walking, there is a feeling of walking on cotton, and sometimes intermittent claudication, rest pain or even tingling. At the same time, due to malnutrition of the extremities of both lower limbs, atrophy and joint deformation may occur, such as arched feet, hammer toes, Charcot joints, etc. Once a wound is accidentally caused, if it is infected, redness, swelling, blisters, and blood blisters will form locally. In severe cases, erosion, ulcers, and even local dry, wet or mixed gangrene will occur.

Diagnosis of diabetic foot

Diabetic foot is caused by damage to the nervous system due to high blood sugar and various pathological and physiological changes. The nerve conduction velocity meter can detect the nerve conduction velocity, objectively reflect the degree of peripheral nerve damage, provide a basis for diagnosis, and achieve early detection and early treatment of diabetic foot to prevent further development of the disease. The diagnosis of peripheral neuropathy is mainly based on changes in nerve conduction velocity. If patients with peripheral neuropathy are examined early and effective treatment is taken in time, the occurrence of foot ulcers can be reduced and gangrene and amputation can be avoided.

With the increasing material and cultural needs of people and the fast-paced urban life, the incidence of diabetes is also increasing, which has become a public problem that threatens people's health. Since many diabetic patients often ignore the changes in their feet, the incidence of diabetic foot (DF) has also increased. In recent years, important progress has been made in the prevention and care of diabetic foot. Studies have shown that regular foot examinations and education for diabetic patients can effectively reduce the incidence of foot complications. Foot examinations include nerve function and blood circulation assessments to detect foot lesions early and treat them in time. In terms of education, diabetic patients receive training in nutrition guidance, foot care skills, and shoe selection to improve their understanding and self-management of diabetic foot. In terms of care, studies have found that the use of appropriate foot care products and techniques, such as foot moisturizers, suitable insoles, and arch supports, can reduce the risk of foot skin damage and ulcers. In addition, foot rehabilitation and rehabilitation training have also been shown to have a positive effect on restoring foot function and reducing disability. These research advances provide more comprehensive and individualized prevention and care strategies for diabetic patients to reduce the risk of diabetic foot complications and improve the quality of life of patients.

Patients with diabetes should pay close attention to high-risk factors that may cause foot ulcers. They should assess whether diabetic patients have foot ulcers or neuropathy, dark red and purple skin on the feet, severe joint deformities, blindness, kidney disease, or inappropriate shoes, among other risk factors. For people who have been diagnosed with diabetes, regular foot examinations are key. This can be achieved by visiting a doctor regularly and undergoing a comprehensive foot assessment. Foot examinations should include nerve function tests (such as single fiber nerve conduction velocity tests) and vascular status assessments (such as hemodynamic tests). For people who have not been diagnosed with diabetes, this is called high-risk population screening. People with high-risk factors for diabetic foot should also be screened. High-risk factors include family history of diabetes, overweight or obesity, hypertension, hyperlipidemia, and abnormal glucose metabolism. For diabetic patients and high-risk groups, regular foot assessments are an important step in preventing diabetic foot [10]. This includes checking the skin condition of the foot, the shape of the arch, and the distribution of plantar pressure. Any abnormal findings, such as ulcers, numbness, or pressure points on the instep or plantar, should be noted and treated promptly.

Foot Care

① Keeping the feet dry and clean is an important aspect of foot care [16]. Develop a good habit of washing your feet every day, use warm water and mild soap to wash your feet, rinse thoroughly and gently dry them. After washing your feet with neutral soap, soak your feet in warm water. Be sure to use a thermometer to test the temperature before soaking your feet to prevent burns. Patients with damaged feet are prohibited from soaking their feet. After soaking your feet, gently wipe your feet with a towel, paying attention to wiping off any water marks left in the cracks of your feet, especially the toes. At the same time, carefully observe the changes in skin color, temperature, and humidity, check for trauma, edema, blisters, skin lesions, and assess the degree of pain and vascular pulsation, sensory function, movement, and reflexes. Keep your feet dry, especially the area between the toes, to prevent fungal and bacterial infections. It is also important to keep the skin of your feet soft and hydrated.

② Use appropriate moisturizers, but avoid applying them on the soles of the feet or between the toes. Sweating can easily cause fungal infections. When washing your feet, you can use medical alcohol to wipe the toe gaps. If the foot skin is dry and the heels are cracked, use sheep fat oil lubricants, apply them evenly on the foot skin, and gently massage to fully absorb them. At the same time, be careful when trimming your toenails, and try to avoid cutting them too short or too sharp to reduce the risk of trauma and internal injuries.

③ Choose the right shoes. Diabetic foot patients should trim their nails regularly to prevent secondary infection from trauma. Choose soft-soled shoes that are of appropriate size, wide toe, thick sole, soft fabric, good breathability, loose and comfortable. Avoid high heels and pointed shoes. Shoes should have sufficient support to reduce foot pressure and friction.

Author: Lu Jibao, Xiaoji Town Central Hospital, Fengnan District, Tangshan City, Hebei Province