Diabetic foot is a clinical picture, associated with diabetes, in which a mixture of neuropathy (involvement of nerves) and arteriopathy (involvement of arteries) produces changes in the anatomy of the foot and subsequently wounds in it that with a bad evolution can end in amputations of a toe, foot or even leg.
Factors that influence its appearance
Diabetic patients with poor glycemic control are more likely to suffer from it, but sometimes it can appear in patients with an apparent good control of their disease.
The initial onset of neurological damage in the form of sensory neuropathy (they begin with a decrease in sensitivity in the feet) causes anatomical deformities to appear at the base of the toes and forefoot, and this, in turn, causes the points of support of the sole of the foot to change, with the consequent appearance of ulcerated areas due to “bad footing”.
If to this situation we add the worsening of blood flow to the foot and infection, we will have the diabetic foot ulcer, which is the point at which many of them end up and which endangers their future viability.
Diagnosis
The first step to diagnose diabetic foot is to detect the lack of sensitivity of the feet and the alteration of its shape.
Secondly, and very important in these patients, the exploration of the pulses in these patients allows to know if they are patients at risk of having diabetic foot.
When wounds appear, it is already a stage that requires aggressive treatment.
Treatment
If wounds appear and there is an arterial circulatory defect, it is essential to perform procedures that send more blood to the foot, such as angioplasty, stents, bypass… If there is also an infection, we can treat it with an intense antibiotic or aggressive surgical cleaning.
Prevention
The most useful for the prevention of diabetic foot is to have a good control of diabetes to avoid the onset of neuropathy.
If the pathology already exists, it is possible to make unloading insoles, wear very comfortable shoes and avoid walking barefoot so as not to make even a small wound.
All these measures are useful to avoid the appearance of this entity, which often has such catastrophic results.