Diabetic Foot

Introduction

Typical complication of chronic neglected hyperglycemia, the diabetic foot is the result of a series of metabolic alterations that weigh heavily on the functional and structural integrity of the blood vessels.

When not properly cared for, the diabetic foot can cause catastrophic consequences such as bleeding ulcers, infections and gangrene.

Planning a prevention program aimed at minimizing the risk of calluses, lesions, ulcers and infections is therefore essential not only for the health and quality of life of the diabetic patient, but also and above all for its own survival.

What to do and what not to do

Please note

Before designing a specific prevention plan for the diabetic - aimed at reducing the risk of complications of the neuropathic foot - it is necessary to identify the patient's risk factors and incorrect living habits.

As we know, due to the reduced sensitivity (neuropathy) to the lower limbs, diabetic patients are perpetually exposed to injuries to the feet, ranging from simple calluses to the most complicated bleeding ulcers. If, in addition to the altered ability to perceive pain and temperature variations, bad circulation at the level of the lower extremities (arteriopathy) is also added, it is clear that an apparently harmless trauma can quickly turn into a ruinous damage for the diabetic.

The table shows some important guidelines that can help the patient to preserve the safety of their feet.

What to do

What not to do

Always use comfortable shoes Wear cotton socks without stiff seams Change the socks one or more times a day Use soft silicone insoles, useful for balancing the weight of the body while walking For pedicures, prefer limes and brushes to scissors Always perform proper personal hygiene of the feet (we recommend contacting the podiatrist) Check the soles of your feet one or more times a day to make sure there are no cuts or abrasions Follow a healthy and balanced diet Apply moisturizing creams to the feet several times a day (an important precaution especially in the presence of dry and dry skin) Wash your feet with warm water and mild soap Always dry your feet very well after bathing: we recommend wrapping with soft cotton towels Contact your doctor in the presence of tingling, leg cramps, altered sensitivity Always monitor your blood sugar Always examine your feet (you can possibly help yourself with a mirror) Practice regular and moderate exercise Always contact an expert to remove calluses and calluses Move the toes often to stimulate circulation

Always wear the same shoes Wear nylon or synthetic socks Cut the nails with pointed scissors Wear sandals, clogs, shoes with heels or flip-flops (high risk of calluses and foot traumas forming) Burst any blisters under your feet Smoking: smoking reduces the blood supply to the feet, thus worsening the circulation Drink alcohol Walk barefoot Use the sharp razor for corns Wear rings on your toes Use direct heat sources on the feet (eg hot water bottles, thermal blankets, etc.): the diabetic does not have the exact perception of heat, therefore the possibility of burns increases Use irritating creams on the feet Use the horsehair glove to exfoliate the skin of the feet Wear elastic stockings Stay in very hot water for a long time Cross your legs for a long time

In the presence of small wounds, abrasions, calluses on the feet or other apparently insignificant traumas, the diabetic should always contact his doctor to intervene as soon as possible.

If it is not possible to prevent the diabetic foot, the management of the same and the prevention of complications prove to be life-saving methods.

What to do if ...

1. ... the diabetic patient notices the presence of an ingrown toenail: in this case, the intervention of a podiatrist is essential to prevent foot infections, abscesses and bleeding ulcers.
2. ... the diabetic patient is suffering from apparently harmless fungal infections such as the nail fungus or athlete's foot: even in these circumstances, the diabetic foot must be immediately subjected to specific antifungal treatments, to eradicate the infection in a short time and prevent the indiscriminate proliferation of mycetes.
3. ... the diabetic stumbles and hits the foot against a pointed object or a wall: considering that any form of trauma increases the risk of complications, it is essential to make sure that the trauma is minor and, otherwise, remedy the injury immediately had undergone.
4. ... the diabetic is a smoker: it is now known that smoking causes micro damage to the small blood vessels, particularly in the lower limbs. The damage induced by smoking slows down the healing process (eg scarring of a possible wound), excessively exposing the patient to the risk of infection, ulcers, gangrene, and therefore amputation.
5. ... the diabetic is subject to calluses, calluses or blisters on the feet: as we know, even a small callus can give rise to a series of very dangerous consequences, which subsequently lead to infections of increasing severity. In such circumstances, in addition to paying close attention to the health of their feet, a diabetic should use specific patches, orthotics or silicone gums that can protect the diabetic foot from trauma and pressure.