Leg ulcers in diabetes

Treatment with folk remedies involves the use of:

  • ointments based on aspen and poplar buds. They are used in equal amounts, dried, pulverized. Softened butter is added to the resulting mixture. Its volume is equal to the amount of dry ingredients. Rye flour is also added to the ointment to achieve a pleasant consistency. With a therapeutic agent, lubricate the affected areas, apply a bandage and hold for 4 hours;
  • egg compress. A handful of hazelnuts is crushed, boiled yolk, iodoform in powder (5 g) are added. Trophic ulcers are pre-treated with hydrogen peroxide. The resulting powder is sprinkled on the wound and bandaged with a tissue dressing. It is recommended not to remove it during the day;
  • vegetable oil. To obtain a positive effect, you must first fry the onions and carrots to a golden hue. The resulting oil is cooled and lubricated the wounds several times a day until the disturbing symptoms are eliminated.

Treatment of trophic ulcers will show a good result if all the recommendations of doctors are followed. These include the use of special orthopedic shoes, maintaining foot hygiene, eliminating damage to the skin on the lower extremities. Also, hypothermia should be excluded, and if any disturbing symptoms are detected, you should immediately consult a doctor.

Originally posted 2016-12-27 10: 54: 07.

More than two million people worldwide suffer from trophic ulcers that appear on the feet and legs. A trophic ulcer is a disease in which deep defects of the epithelium or basement membrane occur, and inflammatory processes are observed.

This disease causes tissue loss on the legs, and after the healing of the ulcer on the skin, scars remain.

Treatment of trophic wounds on the legs, despite the fact that today medicine is very developed, is one of the most complicated processes. With a disease in the cells, a violation of nutritional processes occurs – trophic.

Also, the protective functions of the body are greatly reduced, so the recovery ability is partially lost. One of the most severe types of trophic ulcers is diabetes.

With a disease such as diabetes, a lot of different complications arise, one of them is a diabetic trophic ulcer. This ailment is dangerous in that it is attacked by various infections, which, if not treated, can lead to gangrene and subsequent amputation of the leg.

At the onset of the disease, the lower limbs become less sensitive due to the death of nerve cells. This can be felt if you hold your hand over the leg, which will be cold to the touch.

Also, the patient is haunted by night pain. Symptoms are similar to an arterial ulcer on the legs. However, there is a significant difference:

  1. no intermittent claudication syndrome;
  2. the wound is deeper;
  3. the ulcer is large.

A diabetic ulcer is usually located on the toes. Often a factor in its occurrence is trauma to corns on the sole. Another common cause of ulcers is leg angiopathy in diabetes.

To get rid of trophic ulcers on the lower extremities in diabetes mellitus, the patient selects an individual treatment for each patient. This approach is necessary because there are many causes of ulcerative formations.

To identify these factors, before starting therapy for diabetes mellitus, bacteriological, cytological and histological analyzes are performed. Instrumental diagnostics are often used.

After conducting various studies and establishing an accurate diagnosis, the doctor prescribes the appropriate treatment.

  • Therapy may be surgical,
  • medication
  • local treatment will also join the complex of therapeutic measures, during which the ulcers cleanse pus and dead tissue.

For this, a leg wound in diabetes is treated with antiseptic solutions and ointments that promote skin regeneration and scarring of wounds. In addition, physiotherapy and alternative therapy have an important role in the healing process.

During treatment, the affected area is exposed to negative low pressure (-125 mmHg) using polyurethane dressings.

This method makes it possible:

  1. remove purulent formations from the ulcer;
  2. reduce swelling, size and depth of the wound;
  3. increases blood circulation in the tissues of the legs;
  4. starts the process of formation of a new granulation;
  5. the risk of complications is reduced;
  6. creates a moist environment inside the ulcer that reliably protects against viral infections and bacteria.

Catherization is used to treat hypertensive, venous trophic ulcers that do not heal for a long time.

Virtual amputation is a technique that is in great demand in the treatment of neurotrophic ulcers in diabetes mellitus. The method is based on resection of the metatarsophalangeal joint and bone.

At the same time, the anatomical integrity is not broken at the foot, the foci of bone infection and the problems of excessive pressure are removed.

Percutaneous flashing of venous arterial fistulas. This method is used to treat hypertensive ulcers (Martorell syndrome). The operation is performed to dissociate the fistulas along the edges of the ulcer.

Therapy with medication accompanies any surgical intervention. Drug treatment can also be an independent method of treatment, in the case of certain forms of ulcers in diabetes, mild to moderate.

Depending on the nature of the course of the disease, it is divided into various stages.

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The first stage

At the initial stage of a weeping ulcer, the following medications are included in the course of treatment:

  1. antiallergic drugs (suprastin, tavegil, etc.);
  2. broad-spectrum antibiotics;
  3. antiplatelet agents for intravenous injections (reopoliglyukin, pentoxifylline);
  4. anti-inflammatory (non-steroidal) medications (diclofenac, ketoprofen).

Local therapy at the initial stage is aimed at removing dead cells and bacteria from the ulcer. It refers to:

  1. washing the ulcer with antiseptic solutions based on furatsilina, potassium permanganate, chamomile, celandine, chlorhexidine or a series;
  2. application of compresses with healing creams (streptolaven, levomikol, dioxol), as well as a special dressing for sorption (corbonet).

In some cases, the doctor may prescribe hemosorption, a blood purification procedure.

The second stage

At this stage of drug treatment, at which the healing phase and scar formation begins, the healing ointments (ebermin, solcoseryl, actevigin) and antioxidants (tocopherone) are used in the treatment of trophic ulcers.

Also, the ulcer surface in diabetes is treated with curiosin.

The third stage

At the last stages of drug therapy, the underlying disease that caused the appearance of a trophic ulcer is eliminated.

To increase the effectiveness of physiotherapeutic procedures, one of the hardware measures is prescribed at the healing stage:

  1. Treatment with negative local pressure in the Kravchenko pressure chamber. This method is used for atherosclerotic ulcers.
  2. Ultrasonic low-frequency cavitation. Therapy enhances the effect of antibiotics and antiseptics on viruses inside the ulcer formation.
  3. Magnetic therapy. It is prescribed as a vasodilator, sedative, analgesic and decongestant effect.
  4. Laser Therapy Used to relieve pain, remove inflammation and simulate tissue cell repair.
  5. UV exposure. The procedure is prescribed in order to improve the body’s resistance to a variety of infections.
  6. Therapy with nitrogen and ozone. Improves the absorption of oxygen by skin cells and triggers the growth of connective tissue.
  7. Mud therapy and balneotherapy. Such treatment is prescribed for complete recovery after an illness.

It happens that the ulcer is localized in large areas, so therapy does not bring the necessary results. The wound does not heal and this brings the patient endless torment. Often this phenomenon is characteristic of an exacerbated form of venous insufficiency.

In severe trophic ulcers, a skin transplant is done. The necessary piece of skin is taken from the thigh or buttocks.

After transplanted particles of the epithelium take root and become some stimulants of skin regeneration around the ulcer.

Treating diabetic ulcers is a very laborious process. Such wounds are difficult to clear of pus, and this interferes with healing and recovery. At the healing stage, folk therapy significantly improves the effectiveness of drug treatment.

It consists in washing the ulcer with decoctions and infusions from medicinal herbs, as well as their subsequent treatment with homemade ointments, that is, treatment of the diabetic foot at home is possible.

Strong antiseptic characteristics are possessed by succession, celandine, calendula and chamomile. These herbs do not easily remove inflammation, but also form a young epithelium. After the washing procedure, traditional healers recommend using the following recipes:

  1. A clean wound should be burned with vodka or propolis tincture. After that, ichthyol cream or Vishnevsky ointment, which contains birch tar, is applied to the sore spot.
  1. If the ulcers do not heal for a long time, then use cotton pads that are saturated with tar. The resulting compresses are applied to the wound for 2-3 days, after which they must be replaced with fresh ones. The procedure is repeated until the ulcers disappear completely.
  1. Also an excellent tool in the treatment of trophic ulcers is a powder made from dried prickly tatar leaves. Before starting treatment, the ulcer must be washed with a solution of rivanol. Then it should be sprinkled with prepared healing powder and a bandage. The procedure should be systematically repeated, again and again powdering the affected area of ​​the skin with powder, but the wound should not be washed already. Thanks to the powder from tatarnik, the diabetic ulcer will soon heal.
  • Treatment of diabetic foot and trophic ulcers: how to treat, reviews
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  • Cramps in diabetes in the legs of diabetics

Diabetic foot syndrome: symptoms, signs and treatment

Diabetic foot syndrome is a common cause of lower limb amputation

If you have had diabetes for several years, and even more so, if you have been controlling it poorly all this time, then there is a significant risk of damage to your leg. As you know, any wounds and injuries in patients with diabetes do not heal well. Even small damage can fester, develop gangrene, and the foot will need to be amputated.

This is a common scenario. To avoid it, study and carefully follow the rules for foot care, which are listed below. If your legs hurt due to neuropathy, then read the article “Feet Hurt in Diabetes – How to be treated.” The following describes what to do if the sensitivity in the legs is, on the contrary, lowered. This happens more often.

The diabetic does not feel pain in the legs, changes in temperature, stress, cuts, blisters, pebbles that fall into shoes, etc. You can live with this problem carefree, and then suddenly it turns out that the leg has begun to rot, and you need to lie down on the table to to the surgeon. Follow the recommendations below to maintain the ability to walk “on your own.”

The number of diabetes patients with leg problems is increasing all the time because the incidence of type 2 diabetes is increasing. On the territory of the Russian Federation and the CIS countries, more than 200 specialized offices of the diabetic foot work in regional centers. With the help of new modern methods, doctors are increasingly able to prevent amputations.

Diabetic foot syndrome is treated by a special doctor called a podiatrist. Do not confuse it with a pediatrician.

To find specialists who are close to you, type in the search engine “center of the diabetic foot [your city, regional center]” or “cabinet of the diabetic foot [your city, regional center]”. After that, you will immediately see what there are state medical institutions and private clinics.

Let’s look at what causes foot problems in diabetes. In diabetics, blood circulation in the vessels that feed the legs is often disturbed. Not getting enough nutrition, the skin on the legs becomes especially vulnerable to damage, and they heal slowly. Frost also negatively affects the skin of a person with diabetes, although healthy people tolerate winter cold without problems.

Since the blisters, burns and abrasions of diabetics are painless, they may not pay attention to their problems with their legs until gangrene begins.

Another manifestation of diabetic neuropathy is that the skin on the legs loses the ability to sweat and stays dry all the time. A dry skin, as you know, often crack. Cracks in the skin of the heels can turn into ulcers. Since these ulcers do not hurt, the diabetic does not take therapeutic measures, and the process moves to gangrene.

If diabetes has impaired vision, then developing foot problems becomes even more likely. Because a person does not see well where he steps when walking. Also, the risk of a diabetic foot is increased if the patient’s legs swell due to kidney problems. Because edema increases the volume of the feet. Shoes become cramped, squeeze and injure the feet when walking.

What to do? The main remedy is to bring blood sugar back to normal with a low-carbohydrate diet. This is an essential tool to control type 1 and type 2 diabetes. Normalize your sugar – and the manifestations of diabetic neuropathy will pass. You will get rid of them within a few months, in severe cases – in 2-3 years. Study and follow a type 2 diabetes treatment program (see below) or type 1 diabetes treatment.

Persistent pain can be a symptom of sprains, foot deformities, bruising, overload, improper footwear, or infection.

Redness of the skin is a sign of infection, especially if the skin around the wound turns red. Also, poorly selected shoes or socks can rub the skin.

Leg swelling is a sign of inflammation, infection, improperly selected shoes, heart failure, or impaired blood circulation in the vessels.

An increase in temperature on the surface of the skin means an infection or inflammation that the body is trying to suppress but cannot cope with because the immune system is weakened by diabetes.

Any damage to the skin is serious because an infection can enter it.

Corns means that the shoes are improperly selected, and when walking the load on the foot is not properly distributed.

Fungal diseases of the nails and skin of the feet, ingrown nails – can lead to severe infections.

Pus flows from the wound – a symptom of an infectious infection.

Lameness or difficulty walking may indicate joint problems, a severe infection, or that the shoes are improperly selected.

A fever or chills combined with a wound on the leg is a sign of a serious infection that threatens death or amputation of the limb

Redness of the skin spreads around the wound – which means that the infection intensifies, the body cannot cope with it, and it needs help.

Numbness in the legs is a sign of impaired nerve conduction (diabetic neuropathy).

Leg pain is also a symptom of a diabetic foot, but it is treated separately. Read the article “Leg sore with diabetes: how to treat” for details.

Additional symptoms of circulatory disorders (intermittent claudication):

  • pain in the legs, which intensifies when walking and subsides at rest;
  • hair stops growing on the ankles and feet;
  • the skin on the legs coarsens and becomes dry.
  • corns;
  • blisters;
  • ingrown nails;
  • thumb bursitis;
  • plantar warts;
  • hammer curvature of fingers;
  • dry and cracked skin;
  • fungal disease of the skin of the feet (epidermophytosis of the foot);
  • nail fungus.

Corns arise when some part of the foot is subjected to excessive pressure or rubbing something. As a rule, the reason is poorly selected shoes. It is officially recommended that corns be carefully removed with a pumice stone after a bath. Dr. Bernstein objects: Do not remove corns at all! Do not do this yourself and do not let anyone, including a doctor. Because the wound remains at the place of removal of the corn, which is likely to turn into an ulcer.

A diabetic has his toe callus removed. There was a wound that would heal for a long time, and most likely it would be hit by an infection.

Dr. Bernstein points out that removing corns is the main cause of ulcers, which the infection then infects. Next – gangrene and amputation . Instead of removing corns, order and wear good orthopedic shoes. After this, the load on the foot when walking will be distributed correctly, and the corns will gradually pass by themselves.

Blisters are bulging skin areas filled with fluid. The blister is formed due to the fact that the shoes rub the same area all the time on the foot. A blister may also appear if you wear shoes without socks. To avoid blisters, shoes should fit well and don’t go without socks. If there is a blister on the leg, a diabetic patient must definitely see a specialist. The doctor will apply the bandage correctly. If an infection develops, the doctor will remove the pus from the blister and prescribe antibiotics.

Nails grow if a person does not cut them properly or wears too tight shoes. Do not cut the nails around the edges. It is advisable not to cut them with scissors, but to process them with a nail file. A patient with diabetes should not be left without an ingrown nail, he should see a doctor. Perhaps the doctor decides to remove part of the nail to prevent further ingrowth. This is a lesser evil than an infected wound, gangrene and amputation. If an infection has already appeared in the toe, the doctor will prescribe antibiotics.

Bursitis is a bulge on the outer edge of the big toe. Over time, it can fill with bone tissue and fluid. Bursitis is formed if the thumb deviates to the side to the other fingers. This could be a hereditary problem. High heels and pointed toe shoes also increase your risk.

The bursitis of the big toe on which the ulcer appeared. It is seen that the wound is infected.

Plantar warts are small growths of flesh-colored. Sometimes they have tiny black dots. Plantar warts cause the human papillomavirus. This virus penetrates through minor lesions on the skin of the legs. Warts can be painful and interfere with walking. To reduce their spread, wash your hands each time after touching your soles.

The hammer-like curvature of the fingers occurs due to the fact that one or two joints of the small toes bend unnaturally. This is because the muscles in the foot become weak due to diabetic neuropathy. If there is a problem of curvature of the fingers, then the shape of the feet changes. There may be difficulty walking.

Dry and cracked skin is rough and peeling. Skin color changes, it can itch. This problem is caused by various reasons – high blood sugar, nerve damage and poor blood flow to the legs. Cracks in the skin are dangerous because an infection settles in them. Maintain the moisture and elasticity of the skin of your feet.

Lubricate it regularly with oil, as described below in the “Foot Care: Detailed Instructions” section. If you can not cope and the skin condition worsens, see a doctor. You may be prescribed a prescription for a powerful ointment. Talk with your doctor about vitamin A and zinc supplements. Do not arbitrarily take these funds! Of course, the main thing is to lower blood sugar and keep it stably normal.

  1. Training the patient in skills – daily examination of the feet, changing dressings and other necessary actions.
  2. Control of blood sugar, blood pressure and cholesterol.
  3. Wound treatment – dressing, surgical removal of non-viable tissue.
  4. Antibiotics to fight infection.
  5. The Total Contact Cast dressing, which relieves the affected areas of the foot from excessive pressure.
  6. Restoration of blood circulation in the legs, including through vascular surgery.

Diabetic foot is the set of processes that occur with a long and severe course of diabetes

Stage of the disease

Trophic lesion of the legs in diabetes is not a quick process. In its formation, it goes through several stages of development:

  • Latent stage. At this stage, the trophic defects will not be observed on the skin of the diabetic. The patient may be disturbed: pain in the lower parts of the legs, possibly itching and burning sensation. The color of the skin around the future defect may take on a red, blue tint or become covered with dark spots. Swelling appears.
  • Initial symptoms. The patient may not make significant complaints, but in the areas of existing cracks or injuries, deeper skin defects – erosion – will appear.

Diabetic foot developmental stages

  • Stage of obvious clinical manifestations. A slight skin defect will begin to increase in size as well as depth, with the subsequent formation of a scab. The absence of complaints of pain will be characteristic. If you do not start to treat ulcers, there is a risk that harmful microflora will take root in the wound and then purulent discharge will ooze from the defect.
  • Progression of the pathological process. Local intoxication symptoms join local symptoms in the affected area: temperature, chills, muscle weakness, headache. At this stage, complaints of pain resume, and the degree of pain increases several times. In soft tissues in the area of ​​the defect, as well as in nerves and bones, necrotic processes begin to develop.
  • The appearance of gangrene. If at this stage the patient ignores the treatment of diabetic foot, then the process goes into wet gangrene, which can only be treated surgically.

Diagnostics

The trophic ulcer of the legs makes itself felt already in the later stages, when a skin defect becomes visible. In this case, it is not difficult for a good doctor to visually determine the degree of damage, to assess the condition of the skin around the wound.

Palpation specialist can determine the areas where the veins connecting the superficial and deep vessels begin to come out due to the destruction of soft tissues.

In the initial stages, when the defect is absent, the problem can be detected using instrumental examination methods during prophylactic observation. For this purpose, ultrasound of the venous vessels, as well as duplex scanning, are most widely used.

Leg problems in diabetes can be caused by impaired nerve conduction, clogging of blood vessels that feed the legs, or both. This is called a neuropathic, ischemic, or mixed form of diabetic foot syndrome. The doctor determines the form of the disease and makes a diagnosis in order to prescribe the optimal treatment.

  • Ultrasound of the vessels of the lower extremities;
  • M-mode ultrasound dopplerography (USDG);
  • measurement of the ankle-brachial index;
  • transcutaneous oximetry.

Examination of vibrational sensitivity of the foot to assess the severity of diabetic neuropathy

There is another study – radiopaque angiography. A radioactive contrast agent is injected into the patient’s blood, which “glows” through the walls of the vessels. This study is the most informative, but can cause side effects from the kidneys. Therefore, it is prescribed with caution. However, if a surgical operation is planned to restore blood flow in the vessels, then it is mandatory.

The prognosis depends on the length of diabetes, how well the patient is treated, whether he is motivated to comply with the regimen. Concomitant diseases are also important – atherosclerosis, hypertension, complications of diabetes in the kidneys and eyesight, senile dementia. Therefore, when a diabetic goes to the doctor because of leg problems, the examination should be comprehensive.

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The first step in the diagnosis is to determine the degree of impaired blood supply to tissues and nervous sensitivity.

For this, the following examination methods are used:

  • listening to the patient, history taking;
  • a general blood test, a biochemical blood test and determination of blood sugar levels are performed;
  • thorough examination and palpation of fingers, feet, lower legs, determination of pulsation;
  • the level of sensitivity to heat, pain, touch using special equipment is determined;
  • determination of the level of damage to the skin;
  • bacteriological examination of purulent discharge from a wound with the determination of an infectious agent and its sensitivity to an antibiotic;
  • study of the level of blood coagulation;
  • X-ray of the lower limb and foot in the diagnosis of ulcers, edema, redness of the limb.

Listening to patient complaints should be detailed, with a full list of complaints. Examination of the limb should be detailed, the entire surface of the foot, the sole, the gaps between the fingers, the presence of deformities of the foot are examined. The shin is also carefully examined.

Using hardware methods, we study:

  • pressure in the leg, the level of tissue sensitivity is determined;
  • arteries are scanned to determine the lesion;
  • establishing oxygen saturation of tissues (oximetry);
  • the study of blood vessels using contrast x-rays;
  • CT and magnetic tomography of the limb to determine changes in the tissues of the foot;
  • additionally studied the level of changes in the vessels of the fundus;
  • the depth of the wound is studied, the condition of the tissues around it, the sample for research is taken directly from the wound.

Upon examination, the doctor should diagnose and separate the diabetic ulcer from similar lesions in some other diseases. After examination by a doctor, a technique is chosen how to treat a trophic ulcer in diabetes mellitus.

  1. Stabilization and treatment of the main disease – diabetes mellitus by prescribing antidiabetic drugs, supportive treatment, restorative therapy – the goal is to stabilize and reduce blood sugar levels;
  2. Taking measures to unload the sore leg – orthopedic shoes, the use of a special boot;
  3. Local treatment of ulcers using symptomatic agents and modern dressings;
  4. The use of antibiotics according to bacteriological analysis;
  5. Stabilization and improvement of oxygen supply to tissues;
  6. The use of surgical treatment according to the course of the disease is the removal of necrotic formations in the wound, excision of dead tissue, the use of plastic to close the wound with its own skin flap.

Timely and correct diagnosis and promptly begun treatment of ulcers in diabetes is the only way to avoid losing your leg. With adequate therapy, treatment at home for diabetes will take up to 4 months. In severe complicated lesions on the leg, treatment in the clinic is necessary within 50-60 days.

Arterial parameters are studied using pulse studies, ultrasound (Doppler), magnetic resonance angiography.

An important factor in wound healing is unloading of the limb due to an abnormal distribution of pressure on the foot. At this point, extra attention is paid to the prevention of ulcers.

To unload the limbs, special orthopedic insoles, prostheses of the foot in the absence of part of the fingers or foot are used. For each patient, these devices must be made individually.

If necessary, the patient is prescribed bed rest for the period of treatment, movement in a wheelchair.

Surgical correction of the foot is possible – removal of the thumb while maintaining the foot and part of the bone to correct the load. For unloading with uncomplicated ulcers, special boots of their synthetic materials are used. The boot is a sturdy construction that maintains patient mobility and is superimposed so that the load is removed from the toe of the foot. For dressing and wound care, a window is formed in the structure that limits contact and damage to the wound surface.

The boot can only be removed and used if necessary. With a complicated ulcer, swelling, or a change in limb, this dressing should not be applied.

preventive measures

The main method for the prevention of trophic lesions of the extremities in diabetes is the control of their underlying disease and the timely diagnosis of trophic disorders.

Adjusting blood glucose levels, taking anticoagulants, wearing compression clothes – these measures will significantly improve the condition of the circulatory system and tissue nutrition. With existing diabetes mellitus, trophic lesions of the legs should undergo timely and regular diagnosis: a doctor’s examination, ultrasound, Doppler examination and others.

Prevention

Prevention is the careful implementation of the rules of foot care and daily inspection of the feet. Foot care recommendations are given below. Now we will discuss how to examine the feet of a patient with diabetes, what to look for. Feet should be inspected daily, first from above, and then from the side of the sole. Check the skin between your toes carefully. You may need a mirror for this. It is advisable that someone else participate in the examination of the feet, and not just the diabetic himself.

The task of the examination is not to be missed if new corns, swelling, bruising, painful areas, skin lesions, or any other changes appear. The shape, color and temperature of the foot may change. Sensitivity to touch – weaken or vice versa intensify. If you notice that the changes are proceeding for the worse – the next morning, consult a doctor, do not pull. There may be small fractures and fissures of bones, due to which the foot is swollen, its shape changes. This requires urgent attention from the doctor.

Foot lesions to watch out for in diabetes:

  • accidental cuts and abrasions;
  • blisters after burns (including in a too hot bath);
  • fungal skin diseases, especially between the toes;
  • fungal diseases of the nails;
  • ingrown nails into the skin;
  • corns on the feet and toes (“corns”);
  • bruising, bruising.

Even minor damage can turn into a trophic ulcer, which will be long and difficult to heal. In the case of bacterial infection of the wound, gangrene will develop, and it may turn out that only amputation will save the diabetic from death.

If the skin of the feet becomes darker or vice versa lightens, hair disappears on it – this means that the blood supply to the legs is deteriorating. The worse the supply of oxygen and nutrition to the cells, the longer the damage to the skin heals. Check if the skin’s sensitivity to touch is getting worse. To do this, you can use, for example, feathers.

Diabetic foot syndrome usually develops because the patient’s leg is injured, but he does not feel it. The purpose of the daily examination is to identify negative changes that the diabetic did not notice at the moment they occurred. Doctors now have effective modern dressings and ointments. These are tools that help heal wounds on the legs, prevent infection, gangrene and amputation. But still, you need to see a doctor on time. When gangrene has already begun, there is no other way than amputation.

Worried about a diabetic foot? Consult a doctor immediately, do not pull!

Follow the rules for foot care, inspect the feet daily and consult a doctor as soon as something seems suspicious to you. The main way to prevent and treat a diabetic foot is to lower blood sugar to normal, and then maintain it stably normal, as in healthy people. This can be achieved with type 1 and type 2 diabetes with a low-carb diet.

Control your metabolism – and most of the symptoms of diabetic neuropathy will pass over time. In particular, the sensitivity of the legs will be restored. Also damage to the skin on the legs will heal. But, unfortunately, if the blood vessels are clogged, then their patency just can not be restored. Also, if you had fractures or dislocations of the bones of the foot, then this is incurable.

Diabetic ulcers on the lower extremities are much easier to prevent by educating the patient than to treat long and unsuccessfully. The patient must not:

  • to cut nails with sharp scissors, especially with poor eyesight or severe insensitivity, it is better to handle them with a file;
  • cut the nails too short and cut the corners;
  • use heating pads, heating pads and hot foot baths for warming – insensitivity will cause burns. Water for washing feet should be body temperature, you can keep your feet in water for 10-15 minutes;
  • walking barefoot at home and on the street, the beach – always be comfortable on your feet
  • sunbathing in a hot sun – burns may occur;
  • buy narrow, tight, uncomfortable shoes, open shoes with straps;
  • use cosmetics to remove corns;
  • Wear socks with too tight elastic.
    • regularly inspect the foot, lower leg and all fingers in turn, the gaps between them;
    • regularly grease protruding bones on
  • use pumice and nail file for foot care;
  • after washing your feet, you need to get all the moisture off the feet with a dry soft towel,

    necessarily – gaps between the fingers;

  • warm feet with warm thick socks without elastic;
  • inspect and feel the shoes, determining the presence of pebbles, foreign objects, creases of the insole.

    If a wound, scratch, diaper rash is found, treat it with Miramistin, Chlorhexylin, apply a sterile patch. To cure such lesions, do not use oily ointments. If the wound does not heal, consult a doctor in 2-3 days.

    How to buy shoes

    Buy or order all shoes not in the morning or in the afternoon, but in the evening, because in the evening the maximum foot size. Shoes should be comfortable as soon as you try on them for the first time. It should not be necessary to wear new shoes. Shoes with pointed toes should not be worn. You need shoes with wide and deep space for toes.

    Never wear a sandal with a strap between your toes. Because the strap can rub your skin. Blisters will appear, which will then turn into an ulcer. Do not wear the same shoes for several days in a row. Have a few pairs of comfortable shoes to alternate them every other day. Each time, before putting on a shoe, inspect it from the inside. There should not be any third-party objects – pebbles, etc.

    Do not wear stockings or socks with tight elastic bands that compress the legs and impair blood circulation in the vessels. Do not wear socks with holes or darned. Do not wear socks that are too sore or with thick stitches. Problematic socks can damage the skin of the legs, cause a blister first, then an ulcer and then up to gangrene and amputation. Saving on linen can result in irreparable losses due to disability.

    Orthopedic shoes are the most important preventive measure for diabetic foot syndrome. If the patient wears orthopedic shoes suitable for him, then this reduces the likelihood of ulcers on the foot by 2-3 times.

    Custom made orthopedic shoes.

    A toe cap is a piece of solid material that reinforces shoe socks. In orthopedic shoes there should not be a hard toe cap. The top of the shoe should be soft, comfortable and safe for the diabetic toe. There should be no seams in the interior of orthopedic shoes so that there are no scuffs.

    The sole should be rigid, i.e. solid, not elastic. Thus, the pressure in the area of ​​the front plantar surface of the foot is reduced, and the load on the sections of the foot is distributed more evenly. Orthopedic shoes should be ideally convenient and comfortable from the first fitting.

    After reading the article, you have learned everything you need about diabetic foot syndrome. Numerous photos are presented to help you assess the situation – how badly your legs are affected and what is the prognosis. Diabetic foot is a formidable complication of diabetes that can lead to amputation. However, not all patients are doomed to become disabled.

    Follow the recommendations given above – and guaranteed to save the opportunity to move “on your own.” The main thing is to see a doctor in time as soon as you find any damage to your legs. Doctors now have effective dressings and ointments in their arsenal that fight infection and stimulate healing.

    Diabetic foot syndrome is treated with:

    • careful hygiene of the legs;
    • orthopedic shoes;
    • dressings and ointments that stimulate the healing of ulcers;
    • Total Contact Cast dressings for unloading the affected foot;
    • surgical operations – in extreme cases.

    Do not count on any miracle pills. Do not take antibiotics on your own initiative! The main thing is that the patient begins treatment on time, even if his legs are not yet sore. You can try alpha lipoic acid to relieve diabetic neuropathy and restore sensation in the legs. But the best thing you can do is switch to a low-carbohydrate diet to normalize your blood sugar.

    Read more about the treatment for type 2 diabetes and the treatment for type 1 diabetes. A low-carbohydrate diet lowers sugar and helps keep it stably normal, as in healthy people. Due to this, diabetic neuropathy goes away. Sensitivity in the legs is fully restored. This is a real way to cure a diabetic foot and other complications.

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  • Svetlana Borszavich

    General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
    Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
    The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
    The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.

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