How to prevent the development of foot gangrene in diabetes

The diabetic foot syndrome is one of the most serious complications of diabetes mellitus, it occurs in almost 10%  such patients. Considering that the incidence of diabetes mellitus tends to increase annually, the development of & nbsp; diabetic foot, respectively, increases many times every year.  About 50% of all patients with an established diagnosis of diabetes mellitus are at risk for & nbsp; development of foot gangrene.  And the treatment of diabetic foot in almost half of diabetic patients begins too late in order to save the leg.  Every doctor should know and inform the patient in a timely manner about how to prevent the development of foot gangrene.

Combined classification of diabetic foot syndrome

The diabetic foot syndrome is a threat of development of irreversible gangrenous changes in the leg, arising on the basis of pathological changes in the peripheral nervous system, as well as in the arterial and microcirculatory bed.

In the modern classification, it is customary to distinguish 5 stages of diabetic foot:

• 0 stage: at this stage there are no visible signs of damage to the skin of the foot, but there are minor defects in it, such as dry skin, cracks, hyperkeratosis;
• 1 stage:
• A – a superficial ulcerative defect of the skin develops, in the absence of signs of its infection;
• B – signs of circulatory disorders appear in the ulcerative defect;
• Stage 2:
• A – ulcerative defect, in the formation of which the soft tissues of the foot are involved, but there are still no signs of ischemia;
• B – there are signs of ischemia in the ulcer;
• Stage 3:
• A – bones and tendons are involved in the ulcerative defect, but there are no signs of an infectious deep process;
• B – ulcer involving tendons and bones, and signs of deep infection;
• Stage 4: Gangrene of the leg develops with severe infection.

Causes of diabetic foot syndrome

In the development of gangrene of the foot, the most important factor is the disruption of the normal activity of the peripheral nervous system: sensorimotor and autonomic neuropathy develops. There is dry skin, deformities of the foot, blood circulation is disturbed in areas with impaired innervation. Mechanical damage through constant excessive pressure, for example, tight shoes, which is not felt by the patient, due to disruption of the normal functioning of the nerve endings, leads to the formation of a hematoma and the development of a foot ulcer. Damage  can also  occur all at once, for example,   due to trauma with a sharp object or burn, which will eventually lead to the development of gangrene.

How Diabetic Foot Syndrome is Screened

A diabetic foot screening should be mandatory for all diabetic patients by an endocrinologist. Given the fact that foot gangrene develops much more frequently in type 2 diabetes mellitus than in type 1 diabetes, screening should be carried out, respectively, at least twice a year in the first case, and at least once a year in the second. There are three main steps in foot gangrene screening:

1. Examination of the foot: the appearance of the skin of the foot, its color, and the detection of any damage and deformities are carried out.
2. Palpation of the foot: it is necessary to evaluate the characteristics of the pulse on the tibial arteries of both legs, as well as to determine the temperature of the skin.
3. Sensitivity assessment: performed using a graduated tuning fork, which helps to determine the level of vibration sensitivity. If it decreases, we can talk about the beginning of the development of diabetic foot syndrome.

Methods for preventing the development of foot gangrene

Since a foot ulcer occurs under the influence of mechanical damage, full awareness & nbsp; patient  with diabetes about the risk of gangrene and how to prevent this process is the direct responsibility of the endocrinologist. It is necessary to carry out screening examinations of such patients in a timely and complete manner. The most important preventive measure for the development of a diabetic foot is the wearing of special orthopedic shoes. In such shoes, there should be no internal seams, as well as a hard toe cap, which eliminates the possibility of damage due to mechanical friction of the skin on the shoes. At the same time, the presence of a pliable sole helps to reduce pressure on the tissues of the foot.

 If any defects and injuries are found on the foot of a patient with diabetes mellitus, he should be provided with preventive care in special endocrinological rooms for diabetic foot, where they fight against fungal skin lesions, as well as eliminate areas of hyperkeratosis. If during the examination a trophic ulcer was found on the leg – treatment of her should be carried out immediately, & nbsp; to prevent the transition of the disease to a more severe stage and the occurrence of complications. The most relevant method of therapy  trophic ulcer on the leg today is considered & nbsp; laser treatment. You can undergo this procedure at the clinic of aesthetic medicine "Laser Doctor".

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