Diabetic foot, or diabetic foot syndrome - the most common complication of diabetes that occurs 15-20 years after the onset of the disease upon the occurrence of decompensation stage.
In 90% of cases of diabetic foot syndrome is diagnosed diabetes of the second type. The disease is a necrotizing skin lesions, soft tissue, and in severe cases, bone of the foot. In its final stage of diabetic foot leads to gangrene of the extremities of which two-thirds of patients die from Type II diabetes.
The causes of diabetic foot
Decompensated diabetes is characterized by high blood sugar, as well as sharp jumps in its level. It is destructive to the nerves and blood vessels, initially affects the blood vessels of the microvasculature, and then great. Disturbances of innervation and blood supply leads to failure of trophic tissue. The foot is the part of the body, which is experiencing increased stress and often injured, especially for diabetes, because the skin of diabetes is characterized by dryness, and the skin of the foot often occur hyperkeratoses. As a result of the reduced innervation of the patient does not notice minor injuries - bruises, abrasions, cuts, cracks. But in terms of impaired circulation is reduced protective functions of tissues, and any minor trauma can lead to long-term non-healing wound that accession infection turns into an ulcer.
Types of diabetic foot
In 1991, the First International Symposium on the diabetic foot syndrome, which was worked out a classification of the disease in view of the prevailing destruction, adopted as a basis worldwide medical community. According to this classification, the following types of diabetic foot:
- Neuropathic foot, at which dominate nervous disorders;
- Ischemic foot, dominated violations of the microvascular bed;
- Neuro-ischemic foot, which combines features of the first and second forms.
The most common neuropathic foot, the second highest rate - mixed form, ischemic foot is the most rare manifestation of diabetic foot syndrome. Depending on the species depends approach to treatment of diabetic foot and prognosis.
Symptoms of diabetic foot
Symptoms of diabetic foot have their own characteristics, depending on the form of the disease.
- Symptoms of diabetic foot, neuropathic form. It is characterized by a reduced sensitivity of the foot, the absence of pain, stop the pulse of the arteries without changes, normal skin color. On examination, attention is drawn to the foot deformity that develops due to improper distribution of load on the bones and joints of the foot as a result of impaired innervation. On foot sections hyperkeratosis, blisters, also called load redistribution. For ulcers formed in this form of diabetic foot, characterized by straight edges.
- Symptoms of diabetic foot ischemic shape. No deformation of the foot and corns, preserved sensitivity, pulse to stop the arteries is weak or is not defined. Stops cold, pale in color, often swollen. Ulcers jagged, painful.
- Symptoms of diabetic foot disease when mixed form combines the features of ischemic and neuropathic forms.
Manifestations of diabetic foot syndrome depends on the stage of the disease. The clinic utilizes the classification of diabetic foot according to Wagner:
- Zero stage, or at risk of developing diabetic foot. The foot is deformed, there is hyperkeratosis, corns, but no ulcers.
- The first stage of the diabetic foot. Superficial ulcer, limited outside of the skin.
- The second stage of the diabetic foot. Deep ulcers. The process involves not only the skin but also the subcutaneous fatty tissue, tendons, muscle tissue without bone lesions.
- The third stage of diabetic foot. Deep ulcers with bone tissue.
- The fourth stage of the diabetic foot. Limited gangrene.
- The fifth stage of the diabetic foot. An extensive gangrene.
Diagnosis of diabetic foot
The diagnosis of diabetic foot syndrome is not difficult because of a history of diabetes and a characteristic clinical picture of the disease. For the treatment of matters to establish the form and stage of the process, which is performed neurological examination, a detailed study of blood flow (angiography, Doppler, Doppler, etc.), blood analysis, x-ray stop bacteriological examination content ulcers.
Treatment of diabetic foot
The approach to the treatment of diabetic foot depends on the type of disease, but in any form of the disease is mainly compensation of diabetes and reduced blood sugar levels, as the elimination of the main damaging factor.
In ischemic form of diabetic foot treatment is to restore the blood flow in the limbs, which are used and the therapeutic and surgical methods. Prescribe medication drugs that improve blood circulation and reduce swelling, as well as anti-bacterial agents. Of the surgical methods used percutaneous transluminal angioplasty (operation that restores blood flow in vessels without cutting the skin, through a puncture in the artery); trombarteriektomiyu or distal vein bypass grafting. For the injured limb sparing regimen created, performed local treatment of ulcers with antiseptics.
Treatment of diabetic foot in neuropathic and mixed forms is also in the local treatment of ulcers, a common antibiotic therapy and improve trophism stop, but special attention is paid to the restoration of normal innervation, which are used drugs that enhance metabolism. The importance in the treatment of diabetic foot is smoking cessation as tobacco has a negative impact on microvasculature, in the case of smoking, most activities can be ineffective or have only a temporary effect.
The use of folk remedies for the treatment of diabetic foot
The patient with diabetic foot disease folk remedies in the treatment can be recommended as auxiliary, as with prolonged use of traditional medicines can be effective. Another advantage of the application is its mild action, to do no harm.
For the treatment of diabetic foot folk remedies tend to use different drugs of natural origin in the form of baths, lotions and compresses. Widely used decoctions and infusions of herbs - chamomile, sage, eucalyptus, celandine. Made wound healing herbal paste or bee products, which are imposed by the band for a period of several minutes to several hours.
However, it should be said that the development of severe stages of the disease do not rely on traditional remedies, as in this case, treatment of diabetic foot medical intervention requires the active and urgent measures of care.