Diabetes is a chronic disease that affects 4% of the Spanish population. It causes a significant increase in glucose (sugar) levels in the blood. This occurs when there is a shortage or absence of insulin secretion. Insulin is a hormone secreted by the pancreas that helps glucose from food enter the cells to give them energy. If there is not enough insulin, glucose stays in the blood, causing serious health problems over time.
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A diabetic foot is a clinical disorder of neuropathic origin (involvement in the nerves) and induced by hyperglycemia (high sugar), in which with or without coexistence of ischemia (lack of blood supply), and previous traumatic trigger, produces injury and / or ulceration of the foot.
diabetic foot
The foot of the diabetic should be considered a risk foot, since it is more susceptible to suffer certain types of injuries whether intrinsic or extrinsic. In a significant number of chronic diabetics appear on their feet lesions characterized by trophic disorders of the skin and osteoarticular architecture of the foot It is estimated that half of the amputations of lower limbs in the world occurs in diabetics, diabetes being the The first cause of non-traumatic amputations in developed countries. 15% of patients with diabetes will develop an ulcer throughout their lives.
Causes of diabetic foot injuries
- Peripheral neuropathy (nerve involvement)
- Vasculopathy (Lack of blood supply)
Peripheral neuropathy .
It causes loss of sensation in the foot, not feeling pain, with which injuries are not perceived
It leads to the loss of the function of the intrinsic muscles of the foot, favoring the appearance of deformities, these can favor rubbing, changes in the distribution of the foot supports while walking, predisposing to different points of the foot to the appearance of injuries.
It produces dryness of the skin and atrophy of it, favoring the appearance of cracks.
Vasculopathy (Lack of blood supply)
The constant increase in blood glucose causes the small blood vessels that irrigate the foot to narrow, making the supply of oxygen and essential nutrients insufficient.
The fact that in diabetic people have a decrease in blood flow, makes their injuries take longer to heal and have a high risk of irreversible complications.
Aggravating factor in the diabetic foot
Infection
The diabetic patient is more susceptible to infection, since most long-standing diabetics are immunologically depressed.
The infection is not responsible for the appearance of the lesions, but it intervenes in the evolution of the lesions once they appear.
The greater sensitivity of diabetic patients to infection is due to different causes:
- Absence of pain, which favors the development of extensive cellulitis or an abscess.
- Hyperglycemia, which decreases the body's defenses.
- Vasculopathy, which compromises irrigation and the supply of oxygen.
Prevention
The correct control of diabetes is capable of preventing, delaying and reducing the appearance of these serious injuries.
If you have diabetes, you should:
- Check the blood sugar level.
- If you are a smoker, stop smoking, as tobacco decreases blood flow to the feet.
- Check and take care of your feet every day, especially if you already know that you have a nervous affectation or lack of blood supply.
Risk groups for diabetic ulceration
Patients with:
- History of previous ulceration.
- Peripheral neuropathy
- Ischemic Vascular Disease
- Retinopathy or nephropathy.
- Bone deformities
- History of excess alcohol
- Social isolation.
- Elderly over 70 years
TIPS FOR CARING FOR YOUR FEET
SHOULD
Inspect daily the state of the feet in order to look for flictenas, erosions, scratches, wounds, ulcers, blisters etc. If necessary using a mirror.
care feet
Wash the feet daily, dry carefully especially between the fingers.
- Use neutral soap or gel
- Use warm water, use a thermometer to check it (35-37º).
- Do not have more than 5 minutes feet in the water because it favors maceration in the fingers.
- Use soft sponges to wash the entire foot (especially the fingers).
- Dry the foot well, especially between the fingers
Apply moisturizer after bathing, but not in interdigital spaces because of the risk of maceration.
hydration
- Use socks from natural fabrics such as wool and cotton, without seams or patches. Change your socks or stockings every day.
- Inspect the shoes always before use, looking for possible defects or foreign objects.
- Wear good quality shoes The shoe is the one that must be adapted to the foot and never the foot to the shoe. Buy the shoes at the time of the day that has more swollen.
- Wear properly adapted shoes (insoles), avoid pointy shoes and sandals. Accommodate new shoes little by little.
- File the nails straight after washing the feet. Avoid interlocking the sides of the nails.
lime
- Go to the podiatrist regularly, especially in cases of calluses.
- For any injury or injury no matter how small, consult your nurse or doctor without losing time.
- It is advised that every diabetic is vaccinated with tetanus
- Try to walk daily.
SHOULD NOT
- Heat the feet with direct heat sources such as bath water, braziers, hot water bottles, etc.
- Walk barefoot.
- Use scissors, or nail clippers
scissors
- Do not treat hardness and calluses yourself with callicidal products, check with your podiatrist.
- Do not use antiseptic solutions on the feet, as they can burn or injure the skin.
- Do not use tight socks or garters.
- For any injury or injury no matter how small, consult your nurse or doctor without losing time.
- Do not do the cures, you have been instructed to do so.
TIPS ON SHOES AND SOCKS
In conjunction with hygiene standards, good habits of selection and use of footwear must be maintained:
- The footwear should always be used with socks made of natural fabrics, wool or cotton that facilitate perspiration.
- Do not use sandals, flip flops or shoes that leave your feet uncovered.
- The use of shoes with heels and ending in pointed shoes should be avoided.
- The footwear must be comfortable, that does not adjust or cause chafing or injury to the feet.
- The shoes are recommended to be leather, without internal seams, flexible, lightweight, breathable and with the floor that does not slip.
- It is advisable to buy the shoes at the end of the day, when the feet are more swollen, so the shoe that at that time is comfortable, it is guaranteed that it will be throughout the day.
- New shoes should be worn for short periods the first few days, inspecting the feet to see if they cause chafing or foot injuries.
feet
- The purchase of orthopedic shoes must be made under criteria and medical prescription.
- The shoes must be properly maintained, repaired and ensuring the good condition of the soles.
- You should check the inside of the shoe before putting it on, to avoid any element (stone, gravel, any part of the shoe ...) that could injure the foot.
- It is advisable to have more than one pair of shoes to change them every day and to alternate them, thus ensuring a good ventilation of the shoes and avoiding the pressure always in the same areas of the foot.
- The socks and stockings must be made of natural fabrics (linen, cotton, wool) and without seams. No synthetic stockings or socks should be worn, with elastics or rubber bands. They should not be tight or loose in the leg and foot.
- The socks or socks should be changed daily, and if the feet sweat a lot or much exercise has been done more than once a day.