Diabetic Foot Treatment

Causes

Diabetic foot ulcers are open sores or wounds that frequently develop on the bottom of the feet in individuals with diabetes. These ulcers form due to several factors, including

  • Neuropathy: Diabetes can cause nerve damage, resulting in a loss of sensation in the feet. This lack of feeling means that minor cuts, blisters, or pressure sores can go unnoticed and untreated.
  • Poor Circulation: Diabetes can reduce blood flow, particularly to the lower extremities, which slows healing and raises the risk of infection.
  • Hyperglycemia: Elevated blood sugar levels can impair the body’s ability to fight infections and slow the healing process.
  • Foot Deformities: Conditions like bunions, hammertoes, or Charcot foot can alter foot shape, leading to abnormal pressure points that are susceptible to ulcers.
  • Immune System Dysfunction: Diabetes can weaken the immune system, making it harder to fight infections and heal wounds.

Treatment

Effective treatment of diabetic foot ulcers requires a multidisciplinary approach

  • Wound Care: Clean the ulcer and remove dead tissue (debridement) to promote healing. Apply suitable dressings to protect the wound.
  • Infection Control: Use antibiotics to treat any underlying infection. Severe cases might necessitate hospitalization for intravenous antibiotics.
  • Offloading: Relieve pressure from the ulcerated area using special footwear, braces, or even a wheelchair or crutches if necessary.
  • Blood Sugar Control: Maintain optimal blood glucose levels to enhance healing and prevent further complications.
  • Surgery: Surgery may be needed to remove infected tissue or correct deformities that contribute to ulcer formation.
  • Hyperbaric Oxygen Therapy (HBOT): This involves breathing pure oxygen in a pressurized room to accelerate wound healing.

Identifying Symptoms and Diagnosis

Identifying Symptoms

Early identification of symptoms is crucial to prevent complications. Key symptoms include

  • Changes in Skin Color and Temperature: Redness, warmth, or unusual coolness in the feet.
  • Swelling: Persistent swelling in the feet or ankles.
  • Pain: Any unexplained pain or discomfort, even if mild.
  • Open Sores or Wounds: Cuts, blisters, or open sores that do not heal.
  • Drainage: Unusual discharge or foul-smelling drainage from a wound.
  • Calluses or Corns: Thickened skin areas indicating pressure points.
  • Numbness or Tingling: Loss of sensation or tingling in the feet, suggesting possible neuropathy.

Diagnosis

  • Physical Examination: A thorough inspection of the feet for ulcers, deformities, or signs of infection.
  • Neurological Assessment: Tests to evaluate sensation and detect any neuropathy.
  • Vascular Assessment: Checking blood flow to the feet using Doppler ultrasound or other imaging techniques.
  • Wound Culture: Sampling the ulcer to identify any bacterial infection.
  • Imaging Studies: X-rays, MRI, or CT scans to examine bone involvement or deep tissue infection.
  • Blood Tests: Checking for high blood sugar levels, infection markers, and other relevant parameters.

Recurrent Foot Infections

Causes

Recurrent foot infections in diabetics often result from

  • Poorly Managed Diabetes: Consistently high blood sugar levels can weaken the immune response.
  • Incomplete Healing of Previous Infections: Inadequately treated infections can return.
  • Peripheral Neuropathy: Reduced sensation can cause repeated trauma or unnoticed injuries.
  • Poor Circulation: Impaired blood flow hinders healing and makes tissues more susceptible to infection.
  • Compromised Skin Integrity: Dry, cracked skin or calluses can provide entry points for bacteria.

Prevention and Management

  • Strict Glycemic Control: Keep blood sugar levels within the target range.
  • Proper Footwear: Wear well-fitted, protective shoes to prevent injuries.
  • Regular Foot Inspections: Check feet daily for signs of injury, redness, or infection.
  • Prompt Treatment: Address any foot injuries or infections immediately with proper medical care.
  • Moisturizing: Keep skin hydrated to prevent cracks and calluses.
  • Regular Podiatry Visits: Routine check-ups with a podiatrist to manage and prevent foot problems.

Gangrene

Causes

Gangrene occurs when body tissue dies due to a lack of blood supply or severe infection. In diabetics, it is often caused by

  • Severe Infections: Untreated or severe infections that spread can lead to tissue death.
  • Peripheral Artery Disease (PAD): reduced blood flow due to narrowed or blocked arteries.
  • Injury: severe trauma or wounds that become infected.
  • Neuropathy: lack of sensation leading to unnoticed injuries and infections.

Treatment

  • Surgical Intervention: Removal of dead tissue (debridement) or, in severe cases, amputation.
  • Antibiotics: Aggressive antibiotic treatment to control infection.
  • Vascular Surgery: Procedures to restore blood flow to the affected area.
  • Hyperbaric Oxygen Therapy (HBOT): To improve oxygen supply to affected tissues and promote healing.

Prevention and Foot Care

Prevention

Preventing diabetic foot problems involves

  • Blood Sugar Control: Keeping blood sugar levels within the target range.
  • Daily Foot Care: Inspect feet daily, wash them with mild soap and water, and keep them dry, especially between the toes.
  • Moisturizing: Apply lotion to feet to prevent dry skin and cracks, avoiding the area between the toes.
  • Proper Footwear: Wear well-fitted, supportive shoes and avoid walking barefoot.
  • Regular Check-ups: Regular visits to a healthcare provider for foot exams and immediate attention to any problems.

Foot Care

  • Nail Care: Trim toenails straight across and file edges to prevent ingrown nails.
  • Avoid Extreme Temperatures: Protect feet from hot and cold temperatures.
  • Footwear: Choose shoes that fit well and provide adequate support and cushioning. Avoid tight shoes and high heels.
  • Exercise: Engage in regular exercise to promote circulation, with activities that do not put excessive stress on the feet.
  • Smoking Cessation: Quit smoking to improve blood circulation.

Get in Touch

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We would be happy to answer your questions.