Diabetes affects all members of the body and its impact on the feet of the most complications and the incidence and seriousness, which causes the amputation of the lower limbs in whole or in part as the amputation is often the result of foot ulcers and the subsequent infections and gangrene and inflammatory poisoning positive amputation stages Last.
Therefore, diabetic patients should know those complications and their causes to prevent them from falling and the attention of specialists in the care of foot sugar, noting that more than 85% of cases of amputation caused by diabetes and diabetic foot can be avoided.
- Diabetes causes sensory and motor nerves in the legs and most affects the feet.
- Diabetes causes mild, small and microvascular disorders, resulting in a decrease in blood supply to the feet.
- Diabetes causes small joint and foot joint disorders, which can lead to deformities in the feet.
- It causes a lack of immunity to the body and resistance to inflammation, including diabetic foot ulcers.
Diabetic foot is the foot of the diabetic patient who is exposed to ulcers, infections and gangrene due to the group of neurological, arterial and articular disorders caused by diabetic neuropathy + diabetic angiopathy + diabetic arthropathy
As mentioned above, amputation of the lower limbs results from ulcers and complications in the foot.
It is very important that the diabetic knows how this happens to avoid it
1- Diabetic neuropathy, which leads to gradual loss of sensation of pain, temperature, coldness and pressure, in addition to the movement of the muscles and veins of the arteries
- Sensory neuropathy Any contact, pressure, bruising, or bruising can lead to ulcers that may inflame without being felt by the patient, and are difficult to see because of the effect of diabetes on looking and not treated at the onset of the disease.
- Motor neuralpathy, which causes weakness in the muscles of the small foot, leads to warping in the fingers and deformities in the joints that connect the bones of the foot to each other so that the shape of the foot is broken leading to protrusions that can be damaged by the tissue covered by friction in the shoe wall.
This also leads to an imbalance in the distribution of pressure on the feet leading to ulcers in the foot sugar.
2. Angiopathy, where diabetes causes the narrowing of these arteries and reduces their elasticity and natural non-response by constriction or expansion according to the need of the foot to the blood, causing a lack of blood supply (perfusion), which carries oxygen and food to the tissues in the feet, which prevents the healing of ulcers Which is caused by diabetic neuropathy.
3. Arthritis of the feet, which is caused by neuropathy for diabetes, causes the emergence of protrusions and deformities and focuses the weight and friction on the areas of the nuts, which increases the incidence of ulcers.
4. Chronic rise in blood sugar helps prevent wound healing and ulcers. The loss of the body causes immunity to resist germs and inflammation associated with ulcers, which complicates matters further.
As shown in the above, the most important factor in the occurrence of ulcers of diabetic foot is neuropathy, so here are the symptoms that indicate the presence of neuropathy:
- Feeling numb with feet.
- Gradual loss of sensation.
- Feeling burning in the foot.
- Feeling warm or cold feet.
A doctor can show signs of neuropathy by careful examination of the foot by:
• Lack of or lack of feeling of vibrations in the use of chocolate thistle
• The inability of the patient to determine the movement of the direction of the finger.
• Loss or lack of anecdotal response (ankle + knee reflexes).
• no prick pin prick 10 gr. Monofilamel Nylon test.
• Atrophy in the small foot muscles.
• The appearance of deformities of the joints of the foot, especially the fingers.
• The presence of dryness in the skin and lack of sweating feet.
Diabetic nephropathy, which is the main factor in the healing of wounds and ulcers and may help in the formation of ulcers with neuropathy, can be detected and determined by the examination of the arterial pulse and blood pressure in comparison to the pressure of the leg and arm ABI and oxygen pressure measurement With your toes
First class: simple
Second Grade: Average
Third degree: severe
When there are ulcers in the foot sugar is the main cause of amputation of the parties because of the inflammation that accompany them, which are classified by severity to four degrees according to size, pain and secretions and symptoms of the general accompanying them.
Dr.. Ibrahim Jafra