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Diabetic Foot Treatment

Introduction

  • Diabetes mellitus represents several diseases in which high blood glucose levels over time can damage the nerves, kidneys, eyes, and blood vessels
  • Diabetes can also decrease the body's ability to fight infection
  • Foot problems commonly develop in people with diabetes and can quickly become serious
  • Diabetes causes more than 70% lower limb amputations
  • With damage to the nervous system, a person with diabetes may not be able to feel his or her feet properly.
  • Normal sweat secretion and oil production that lubricates the skin of the foot is impaired.
  • These factors together can lead to abnormal pressure on the skin, bones, and joints of the foot during walking and can lead to breakdown of the skin of the foot.
  • Bacterial infection of the skin, connective tissues, muscles, and bones can then occur, these infections can develop into gangrene

Definition

Any infection involving the foot in a person with diabetes originating in a chronic or acute injury to the soft tissues of the foot, with evidence of pre-existing neuropathy and/or ischemia

Who Definition: Infection, ulceration or destruction of deep tissues associated with neurological abnormalities & various degrees of peripheral vascular diseases in the lower limb

Epidemiology

  • 40% - 60% of all non traumatic lower limb amputation
  • 85% of diabetic related foot amputation are preceded by foot ulcer
  • 4 out of 5 ulcer in diabetics are precipitated by trauma
  • 4% -10% is the prevalence of foot ulcer in diabetics
  • After amputation 30% lose other limb in 3 years
  • After amputation 2/3rds die in five years
  • Type II can be worse
  • 15% of diabetic will develop a foot ulcer
  • If the infection spreads to the bloodstream, this process can be life-threatening
 

What are the symptoms of PVD?

For many people, the first signs of PVD begin slowly and irregularly. You may feel discomfort like fatigue and cramping in your legs and feet that gets worse with physical activity due to the lack of blood flow. Other symptoms of PVD include:

Area of painSymptoms
legsreduced hair growth, cramps when lying in bed
legs and armsturn reddish blue or pale
legs and feetthin or pale skin, weak pulses, wounds, or ulcers that won’t heal
toesblue color, severe burning, or thick and opaque toe nails
musclesfeel numb or heavy

Complications of PVD can include:

  • tissue death, which can lead to limb amputation
  • impotence
  • pale skin
  • pain at rest and with movement
  • severe pain that restricts mobility
  • wounds that don’t heal
  • life-threatening infections of the bones and blood stream
 

How do you diagnose PVD?

  • Doppler
  • Ankle brachial index
  • Ct angiography
  • Mr angiography
 

How do you treat PVD?

  • Life style modification-stop smoking,exercise
  • Medication-antiplatelets,statins
  • Angioplasty
  • Bypass surgery
 
 

Make an Appoitnment

PSRI Hospital

Press Enclave Marg, Sheikh Sarai II, New Delhi

Call Us:
9212087571