Diabetic foot

Diabetic foot, or syndrome of diabetic foot is the most frequent complication of a diabetes mellitus arising in 15-20 years after the beginning of a disease at approach of a stage of a decompensation.

In 90% of cases the syndrome of diabetic foot is diagnosed at a diabetes mellitus of the second type. The disease represents ulcer and necrotic damage of skin, soft tissues, and in hard cases and a bone tissue of foot. In the final stage diabetic foot leads to gangrene of an extremity from which two thirds of patients with a diabetes mellitus of the second type perish.

Reasons of development of a syndrome of diabetic foot

The stage of a decompensation of a diabetes mellitus is characterized by the high content of sugar in blood, and also sharp jumps of its level. It irritates destructively and vessels, are surprised vessels of a microcirculator bed in the beginning, and then and big. Disturbances of an innervation and blood supply result in insufficiency of a trophicity of fabrics. Foot is that part of a body which experiences the raised strain and is often injured, especially at diabetes as skin at diabetes differs in dryness, and on foot skin often there are giperkeratoza. As a result of a reduced innervation the patient does not notice small injuries – bruises, attritions, cuts, cracks. But in the conditions of the broken blood circulation protective function of fabrics is reduced, and any insignificant injury can bring to is long to not healing wound which at accession of an infection turns into an ulcer.

Types of diabetic foot

In 1991 the First International symposium on a syndrome of diabetic foot where the classification of this disease taking into account the prevailing defeat assumed as a basis by world medical community was developed took place. According to this classification, allocate the following types of diabetic foot:

• Neyropatichesky foot at which disturbances of an innervation prevail;
• Ischemic foot, disturbances from a microvascular bed prevail;
• The neuro and ischemic foot combining signs of the first and second forms.

Most often neyropatichesky foot, on the second place on frequency – the mixed form meets, ischemic foot is the most rare manifestation of a syndrome of diabetic foot. Depending on a look, approach to treatment of diabetic foot and the forecast of a disease depends.

Symptoms of diabetic foot

Symptoms of diabetic foot have the features, depending on a disease form.

• Symptoms of diabetic foot, neyropatichesky form. Pulse on arteries of feet without changes, skin of usual color is characterized by reduced sensitivity of foot, lack of pain. At survey the foot deformirovannost developing because of the wrong distribution of load of bones and joints of foot as a result of the broken innervation attracts attention. On foot the sites of a hyperkeratosis, callosities which are also caused by redistribution of loading. Smooth edges are characteristic of the ulcers which are formed at this form of diabetic foot.
• Symptoms of diabetic foot, ischemic form. There is no deformation of foot and callosity, sensitivity is kept, pulse on arteries of feet weak or is not defined. Feet are cold, pale color, are often edematous. Ulcers have uneven edges, are painful.
• Symptoms of diabetic foot at the mixed form of a disease combine signs of ischemic and neyropatichesky forms.

Manifestations of a syndrome of diabetic foot depends also on a disease stage. In clinic classification of diabetic foot by Wagner is applied:

• Zero stage, or risk group of development of diabetic foot. Foot is deformed, there is a hyperkeratosis, callosities, but there are no ulcers.
• First stage of diabetic foot. The superficial ulcer limited to skin limits.
• Second stage of diabetic foot. Deep ulcer. Not only skin, but also a hypodermic fatty tissue, sinews, muscular tissue, without damage of bones are involved in process.
• Third stage of diabetic foot. A deep ulcer with damage of a bone tissue.
• Fourth stage of diabetic foot. Limited gangrene.
• Fifth stage of diabetic foot. Extensive gangrene.

Diagnosis of diabetic foot

The diagnosis of a syndrome of diabetic foot comes easy because of existence in the anamnesis of diabetes and a characteristic clinical picture of a disease. For treatment establishment of a form and stage of process matters for what conduct a neurologic research, a detailed research of a blood-groove (an angiography, a dopplerometriya, doppler sonography, etc.), a blood analysis, a X-ray analysis of feet, a bacteriological research of contents of an ulcer.

Treatment of diabetic foot

Approach to treatment of diabetic foot depends on a type of a disease, however at any form of a disease of the main thing compensation of a diabetes mellitus and decrease in level of sugar in blood as elimination of the major disturbing factor is.

At an ischemic form treatment of diabetic foot consists in recovery of a blood-groove in an extremity for what use both therapeutic, and surgical methods. Appoint the medicamentous drugs which are improving blood circulation and removing hypostases, and also antibacterial agents. From surgical methods apply transdermal transluminal angioplasty (operation at which recover a blood stream in vessels without cutting skin, through a puncture in an artery); trombarteriektomiya or distal shunting by a vein. For the injured extremity the sparing mode is created, local processing of ulcers is carried out by antiseptic agents.

Treatment of diabetic foot in the neyropatichesky and mixed forms also consists in local processing of ulcers, to the general antibacterial therapy and improvement of a trophicity of feet, but special attention is paid to recovery of a normal innervation for what the drugs improving metabolism are used. At treatment of diabetic foot the refusal of smoking as tobacco has a negative impact on a microvascular bed is important, and in case of smoking the majority of actions can be inefficient or have only short-term effect.

Use of folk remedies at treatment of diabetic foot

Diabetic foot folk remedies at treatment can be recommended to the patient with a disease as auxiliary as at prolonged use of folk remedy can give good effect. One more advantage of their use is their soft action which is not doing harm.

For treatment of diabetic foot folk remedies as a rule use various medicinal substances of a natural origin in the form of trays, lotions and compresses. Broths and infusions of officinal herbs – camomiles pharmaceutical, a sage, an eucalyptus, a celandine are widely applied. Wound healing pastes on the basis of herbs or products of beekeeping which are imposed under a bandage for a period of several minutes till several o'clock are made.

However it is necessary to tell that at development of serious stages of a disease you should not rely on folk remedies as in this case treatment of diabetic foot demands active medical intervention and acceptance of urgent measures of medical care.