Diabetic foot


Is it good for people with diabetes to soak their feet?
Whether soaking the feet is beneficial for diabetic foot or not first depends on whether there are any wounds on the feet. If it is a grade 0 diabetic foot, where the diabetic only experiences abnormal sensations, numbness, or pain in the foot without any wound, then soaking the feet is permissible. However, it is crucial to be mindful of the water temperature during soaking; it generally should not exceed 40°C to avoid burns. If the diabetic foot has open wounds, foot soaking is not recommended. Soaking feet with wounds can easily lead to increased infection of the wounds.


How to relieve pain in diabetic foot?
If diabetic foot is combined with pain, it often depends on the severity of the diabetic foot. It has a Wagner grading system. If there is an obvious wound that extends to the bone, anti-infection treatment is very important, and surgical assessment is necessary to determine if the foot can be saved. If the wound is superficial and only involves the epidermis, local anti-infection and circulation improvement are fundamental. In such cases, COX-2 inhibitors and non-steroidal analgesic drugs may be used. If the pain is caused by peripheral neuropathy, the first step is to nourish the nerves, for example with mecobalamin, and treat the neuropathy with drugs like epalrestat, along with drugs like cilostazol that improve microcirculation. Effective treatments targeted at this type of neuropathic pain include drugs like pregabalin and etoricoxib, designed for bone pain, and gabapentin-related medications can also be used. (Medication should be used under the guidance of a doctor.)


Care of diabetic foot wounds
In terms of caring for diabetic foot wounds, medical treatment, surgical intervention, or debridement is of course necessary. Regarding foot care, it's important to examine the condition of the wound. The primary principle is first, in dietary care, to ensure a high protein diet under the allowance of liver and kidney functions, and then a low-fat diet. It's important to include high-quality protein, which is beneficial for wound healing. Locally, the wound area must be kept clean and dry. It is crucial to maintain a concept of sterility, avoiding actions like breathing over the wound with the mouth or touching the wound area with hands. The wound should be cleaned or locally disinfected regularly every day. Additionally, foot wounds in diabetics should slightly elevate the feet to facilitate blood return. Moreover, regular observations of changes in the wound should be made and communicated timely to the doctors at the hospital.


Symptoms of diabetic foot
The symptoms of diabetic foot can be categorized into those without wounds, commonly referred to as stage 0 diabetic foot. The main symptoms of stage 0 diabetic foot include lower limb paralysis, pain, intermittent claudication, severe lancinating pain, and other sensory abnormalities. This is what constitutes a stage 0 diabetic foot. Stages 1 to 5 of diabetic foot progressively involve wound ulceration, typically presenting as progressive ulceration, pain, and exudation. Therefore, it is recommended for diabetic foot patients to seek timely treatment from an endocrinology specialist, and to use medications under the guidance of a doctor to avoid worsening of diabetic foot infections and to prevent severe consequences.


What to eat for diabetic foot?
Typically, patients with diabetic foot have had diabetes for a long period, and often have diabetic nephropathy, or serious hypoproteinemia and malnutrition. In such cases, patients with diabetic foot need to supplement with protein, specifically high-quality protein, and must avoid low-quality protein. What constitutes low-quality protein? This includes soy products and plant proteins. High-quality protein, on the other hand, includes sources like milk, eggs, poultry, and meat. However, if renal insufficiency is present and creatinine levels have increased, the amount of protein must be limited. Protein intake should be calculated based on body weight and creatinine levels, using different coefficients to determine the total daily protein allowance. It is crucial to make these protein adjustments within the framework of a diabetic diet.


Can diabetic foot be cured?
Diabetic foot can potentially be cured, and it can improve, but it depends on the specific circumstances. Diabetic foot varies in severity and is classified into different levels. In medical terms, it is classified based on its appearance, and different classifications have different prognoses. Even within the same classification, factors like the patient's vascular condition, baseline nutritional status, age, duration of diabetes, and many other factors can influence whether diabetic foot can be cured. In clinical practice, there are many diabetic foot patients who, after comprehensive treatment, achieve complete wound healing. Therefore, whether diabetic foot can be cured depends on many factors.


How to treat diabetic foot early
First of all, in the early stages of diabetes, it is necessary to control blood sugar to prevent the occurrence of diabetic foot. If diabetic foot has already appeared in the early stages of diabetes, then it is important to prevent the further development of diabetic foot into late-stage ulceration and gangrene. Firstly, proper care should be taken to avoid damage to the skin. Secondly, it is crucial to control blood sugar, complete examination of lower limb vascular ultrasonography or angiography, ascertain the extent of lower limb vascular lesions, and improve blood circulation. If there is an occlusion of the blood vessels in the lower limbs, surgical methods should be used as soon as possible to open the vessels and maintain blood supply, to prevent further deterioration.


What are the symptoms of diabetic foot infection?
Symptoms of diabetic foot infections can include localized gradual wound ulceration, suppuration, and odor. In severe cases, patients may observe necrosis of the foot with a dark color. Some patients may experience systemic effects, including fever. Therefore, the progression of diabetic foot can be rapid. It is recommended that diabetic patients seek medical attention promptly when they notice any wound ulceration to prevent worsening of the infection.


What to eat for diabetic foot
The treatment of diabetic foot begins with good blood sugar control. Therefore, dietary control is necessary for diabetic foot. For diabetic patients, it is required to eat three meals a day at regular times and avoid multiple smaller meals or snacks. Foods such as fruits, nuts, and those high in fats should be eaten less frequently. Additionally, liquid foods like soups and porridges should also be reduced. Only when blood sugar is well-controlled can the treatment of diabetic foot be effective.


Symptoms of diabetic foot
Diabetic foot is one of the severe chronic complications of diabetes, generally referred to as the abnormalities in the lower limbs caused by diabetic vascular neuropathy. Diabetic foot with gangrene of the extremity due to concurrent infection is referred to as diabetic foot with gangrene of the extremity, representing a serious stage in the progression of diabetic foot. The main symptoms of diabetic foot include: first, subcutaneous fat atrophy, thinning of the skin, common pigmentation spots on the shin, no hair on the feet and toes, and thickening of the toenails often accompanied by fungal infections; second, atrophy of the extremity muscles, malnutrition, poor muscle tone, and susceptibility to injury in joints and ligaments; third, visible sinking of the finger joints, joint bending, weakening or disappearance of foot deformities, and cool, swollen skin at the extremities; fourth, patients often experience extremity pain, numbness, sensory abnormalities, and dull or absent deep and superficial reflexes. In the initial stages of diabetic foot gangrene, blistering, blood blisters, erosion, and infection can gradually develop into ulcers, gangrene, or necrosis. Clinically, this is manifested as localized redness, swelling, increased skin temperature, pain, functional impairment, and the presence of purulent secretions, sometimes accompanied by a foul odor.