Diabetes has become a common chronic disease, affecting the lives of hundreds of millions of people around the world. Among them, diabetic foot ulcers, as one of the most serious and common complications of diabetes, not only increase the pain and economic burden of patients, but also may threaten their lives. According to statistics, about 15% to 25% of diabetic patients will experience foot ulcers in their lifetime.
What is a diabetic foot ulcer?
Diabetic foot ulcers refer to the phenomenon that skin damage is difficult to heal due to long-term high blood sugar damage to blood vessels and nervous system, resulting in poor blood circulation and loss of sensation in the lower limbs. These ulcers usually appear around the toes, soles or ankles. They may be minor wounds or blisters in the early stage, but if not treated in time, they may deteriorate rapidly, forming deep ulcers and even causing infections, and eventually requiring amputation to save lives.
Risk factors for diabetic foot ulcers
1. Hyperglycemia: Sustained high blood sugar levels are the main cause of diabetic foot ulcers. It damages small blood vessels, reduces blood flow to the feet, and also weakens the immune system, making it more difficult for the body to fight infection.
2. Neuropathy: Peripheral neuropathy caused by diabetes can cause the feet to lose pain and other protective sensations. Patients may not be able to detect injuries or pressure points, which can lead to ulcers.
3. Circulatory disorders: Vascular problems such as arteriosclerosis can affect the blood supply to the feet and increase the risk of ulcers.
4. Abnormal foot structure: Such as flat feet and hammer toes, these conditions can change the pressure distribution of the feet and cause excessive local pressure.
5. Bad lifestyle habits: Smoking, drinking, and lack of exercise can aggravate the progression of the disease.
6. Ageing: As we age, the skin becomes more fragile and its ability to repair itself decreases.
Symptoms of diabetic foot ulcers
The symptoms of diabetic foot ulcers vary, mainly including the following aspects:
1. Darkening of skin tissue: If diabetic patients do not receive timely and effective treatment, local blood vessels may be blocked, causing darkening of skin tissue.
2. Pain: When the condition is relatively serious, local nerves may be compressed or damaged, resulting in dull pain, local numbness or tingling.
3. Paresthesia: Due to the influence of neuropathy, patients may not be able to feel the pain, pressure and temperature changes in the feet, resulting in paresthesia.
4. Cool skin on the extremities: Poor blood circulation may cause cool skin on the extremities.
5. Intermittent claudication: Stenosis of blood vessels in the lower limbs may affect blood circulation in the lower limbs, leading to intermittent claudication.
Prevention measures for diabetic foot ulcers
Faced with the serious threat of diabetic foot ulcers, prevention is particularly important. Here are some effective preventive measures:
1. Good metabolic management:
Blood sugar management: For patients with diabetic foot, blood sugar control should be actively carried out, insulin or other hypoglycemic drugs should be used to keep blood sugar stable.
Regular inspection: Check the integrity of the foot skin every day, whether there are any cracks, redness, swelling, temperature changes or abnormal sensations, and seek medical attention in time if any abnormalities are found.
2. Choose the right shoes and socks:
Avoid wearing unsuitable shoes such as high heels and pointed shoes, and choose shoes and socks that are breathable, comfortable, loose and elastic.
Check the shoes every day for foreign objects such as sand to reduce foot pressure and reduce the chance of ulceration.
3. Protect foot skin:
Avoid long-term foot soaking, using hot water bottles and other behaviors that may cause burns.
Keep the foot skin clean and dry, and avoid cutting the nails too short and with barbs when trimming to reduce the risk of skin damage and infection.
Use mild cleansers and moisturizers to keep the foot skin healthy.
4. Avoid trauma:
When doing outdoor activities, pay attention to protecting your feet and avoid walking barefoot to avoid infection.
Treatment methods for diabetic foot ulcers
The treatment of diabetic foot ulcers requires targeted treatment according to the severity of the ulcer, including comprehensive measures such as drug treatment, surgical treatment, and improving blood circulation.
1. Wound debridement treatment: If the patient has foot ulcers, the wound should be debridemented in time. After seeing a doctor, follow the doctor's instructions to use iodine tincture, saline, etc. to disinfect the wound locally, remove necrotic tissue, and prevent the spread of infection.
2. Anti-infection treatment: The ulcer site is easy for bacteria to enter and cause infection. Therefore, anti-infection treatment is required. Patients can use drugs such as penicillin V potassium tablets and amoxicillin granules for treatment under the guidance of a doctor.
3. Hypoglycemic treatment: Since foot ulcers are caused by diabetes, the primary disease still needs to be treated. Patients can use drugs such as aspart insulin injection and degludec insulin injection under the guidance of a doctor to control blood sugar levels.
4. Improve blood circulation:
Improving blood circulation in diabetic patients is crucial for preventing and treating diabetic foot ulcers. Drugs such as nitroglycerin and other vasodilators can be used to increase blood supply to the foot.
Physical therapy such as infrared irradiation and ultrasound therapy can use physical effects to promote vasodilation and accelerate blood circulation.
5. Surgical treatment: In some severe cases, surgery may be required to treat the ulcerated area. The decision to intervene surgically should be evaluated by the doctor, and the most appropriate treatment method should be selected according to the specific situation. Surgery usually includes debridement, toe amputation, wound repair, skin grafting, amputation, etc. The purpose is to remove necrotic tissue, reduce infection, and promote wound healing.
Rehabilitation care for diabetic foot ulcers
Rehabilitation care is equally important for patients with diabetic foot ulcers after treatment. The following are some suggestions for rehabilitation care:
1. Keep the wound clean: Patients change the dressing under the guidance of the doctor to keep the wound clean and dry to prevent infection.
2. Regular follow-up: Regular review, observe changes in the condition, and adjust the treatment plan in time.
3. Reasonable diet and exercise: Maintain a balanced diet and eat foods rich in nutrients such as vitamins and proteins, such as vegetables, fruits, lean meat, etc.
4. Appropriate aerobic exercise, such as walking and jogging, can help promote blood circulation and strengthen physical fitness.
5. Psychological support: When facing surgical treatment and rehabilitation, patients may have negative emotions such as anxiety and fear. At this time, psychological support from family members and medical staff is needed to help patients maintain a positive attitude and cooperate with treatment.
Although diabetic foot ulcers are terrible, they are not invincible. Through active lifestyle changes, strict blood sugar management and careful foot care, we can greatly reduce the incidence and the harm it brings.