Diabetic foot


Where does diabetic foot hurt?
Diabetic foot refers to those with a history of diabetes who subsequently develop skin ulceration and pus formation on the feet, which can progress to localized gangrene or gangrene of the entire foot. This condition is then termed as diabetic foot. It is usually due to three factors: The first is vascular factors, often accompanied by arterial narrowing in both lower limbs, leading to ischemia and hypoxia. The second is neurological factors, typically accompanied by peripheral neuropathy, causing numbness in both feet and insensitivity to pain, thus often pain is not felt. The third factor involves the presence of an infection. These three factors together make it easy for diabetic foot to develop. Therefore, most patients with diabetic foot do not feel pain. However, if the neuropathy is relatively mild or is a painful neuropathy, these patients may feel pain in their feet or at the site of skin ulceration.


What to eat for diabetic foot
For patients with diabetic foot ulcers, first, their diet should control blood sugar. Foods with a high glycemic index like porridge, glutinous rice, and rice noodle rolls should be avoided. Additionally, sweet foods are also off-limits; it's important for meals to be regular and measured. Second, as patients with diabetic foot ulcers need nutrients for wound healing, they can eat foods high in protein such as eggs, fish, fish soup, and lean meats to promote wound healing. Third, if the patient also has high blood lipids, it's advisable to maintain a light diet and avoid greasy foods.


Care for diabetic foot
The first fundamental step is monitoring blood glucose; good control of blood glucose levels is essential for the effective management of diabetic foot problems. Secondly, attention must be paid to the protection of the wound. It's crucial to keep the wound clean, perform regular cleaning and disinfection, and when necessary, debride necrotic tissue thoroughly. For instance, if there is a sinus tract or deep ulceration, it is essential to open the wound and ensure drainage, removing all necrotic tissue inside. Thirdly, footwear choice is critical for patients with diabetic foot; it is important to wear shoes that are loose fitting, moderately soft yet firm, and capable of evenly distributing pressure across the footbed. There are shoes specially designed for those with diabetic foot, and these can be custom-made. Other considerations include maintaining good blood pressure control and ensuring adequate nutrition to support wound healing, including sufficient protein intake, which plays a vital role in promoting wound repair.


How to deal with diabetic foot ulcers.
For diabetic foot ulcers, the first step is to assess the severity of the foot wound. Treatment definitely requires timely consultation with an endocrinology specialist. The first step is to control blood sugar levels to meet targets; second, control blood pressure and blood lipids; third, administer systemic anti-infection treatment, choosing a sensitive antibiotic based on the wound secretion cultures; fourth, local wound management involves debridement and dressing changes depending on the condition of the wound; fifth, an ultrasound of the lower limb vessels can be conducted to check for arterial sclerosis or occlusion, subsequently using medication to improve circulation.


Can diabetic foot be cured?
Diabetes has many complications, and once detected, the complications of diabetes cannot be completely cured. Diabetic foot is a relatively serious complication of diabetes. Diabetic foot generally involves many years of underlying vascular and nerve damage that eventually leads to infection or ulceration, resulting in the final formation of diabetic foot. Whether such a serious complication can be cured actually depends on the duration of the patient’s condition, the extent of the lesion, and most importantly, how soon they seek medical attention. For instance, if the infection is very severe, has damaged the bone, or if there is dry gangrene with local tissue necrosis in the foot, then no matter what conservative treatment is applied, it will not be effective, and surgical amputation will be the only option, meaning the foot cannot be saved. However, if some individuals only have early-stage skin ulceration that cannot heal, or if there is an infection that is not very severe, and they seek medical attention early, controlling the infection and treating with nerve nutrition and vascular protection can actually heal the ulcerated area of the foot.


incidence of diabetic foot
As the number of diabetic patients increases, the incidence of diabetic foot also rises. Currently, the prevalence of diabetic foot in China is 5.7%, which is below the global average. Diabetic foot primarily occurs in patients who have had diabetes for over ten years, often due to poor blood sugar control and inadequate care. Diabetic foot is also one of the three major non-traumatic causes of amputation. Therefore, the most severe consequence of diabetic foot is amputation.


Is it good for people with diabetes to soak their feet?
Diabetic foot is primarily classified into a level 0 diabetic foot and levels 1 to 5 diabetic foot. If it is a level 0 diabetic foot and the patient does not have any wounds, then soaking the feet is permissible. Level 0 diabetic foot mainly refers to a high-risk diabetic foot, in which case soaking is allowed. However, care must be taken to ensure that the water temperature is not too high to avoid scalding the skin. If the diabetic foot has reached levels 1 to 5, where the patient has wounds and ulcerations, soaking the feet is not recommended, as it can easily worsen and exacerbate the wound ulcerations. Therefore, people with diabetes should consider their individual conditions to determine whether foot soaking is suitable.