0.06 CME

مرض السكري والعناية بالقدم: نظرة عامة

المتحدث: Dr.M.S.Alam

Clinical Associate Apollo Medics Super Specialty Hospital

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وصف

Foot problems are common in people with diabetes, and they can be serious if left untreated. Diabetes can cause nerve damage (neuropathy) and poor circulation, which can make it difficult for you to feel or notice injuries or infections on your feet. This can lead to ulcers, infections, and even amputations. Some common foot problems associated with diabetes include:Calluses: Thick, hardened areas of skin that develop from repeated pressure or friction. Corns: Small, raised bumps of thickened skin that usually develop on the toes. Dry skin: Dry, cracked skin that can lead to infection. Fungal infections: Infections caused by fungi, such as athlete's foot or toenail fungus. Ingrown toenails: Toenails that grow into the skin around the nail, causing pain and infection. Ulcers: Open sores that can develop on the feet, particularly on the balls of the feet or the bottom of the toes. Charcot foot: A condition in which the bones in the foot weaken and fracture, causing the foot to become deformed.Gangrene: The death of tissue due to a lack of blood flow, which can lead to amputation.

ملخص

  • Diabetes is a disease characterized by deficient or resistant insulin, leading to hyperglycemia, potentially with ketones in the urine. The two primary types, Type 1 and Type 2, can result in neurological, microvascular, and macrovascular complications. Diabetic foot is a complication arising from prolonged hyperglycemia, impacting neurological and vascular systems.
  • Several factors contribute to the development of diabetic foot, including uncontrolled hyperglycemia, tobacco use due to nicotine's vasoconstrictive properties, deranged lipid profiles, cardiovascular disease, hypertension, and being overweight.
  • Symptoms of diabetic foot may include pain or cramps in the calf or thigh muscles during physical activity, color changes in the lower extremities, tingling or burning sensations in the feet, loss of sensation, and reduced or absent pulses in the dorsalis pedis and posterior tibial arteries. Other signs include cracked and dry skin, thick toenails, hair loss on the feet and lower legs, fungal infections, blisters, sores, ulcers, corns, ingrown toenails, non-healing wounds, and changes in foot shape.
  • Foot care involves daily inspection, washing, and moisturizing. Wearing well-fitted and comfortable shoes, avoiding bare feet, and proper toenail trimming (straight across) are crucial. Corns and calluses should be addressed by a physician. Regular foot examinations are essential, especially during follow-up appointments, to monitor blood flow and identify potential problems.
  • Treatment for diabetic foot necessitates early intervention, including good glycemic and hypertension control (HbA1c less than 7), lipid control, proper foot care, pain management, and medication to enhance blood flow. Cleaning and draining wounds, debridement of dead tissue, antibiotics to combat secondary infections, and weight-bearing relief with devices like wheelchairs are important components. Maintaining a balanced diet is also essential.

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