Causes of diabetic foot

Written by Li Hui Zhi
Endocrinology
Updated on September 21, 2024
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The main causes of diabetic foot are as follows: The first one is poor blood sugar control in patients. Some patients have long neglected their blood sugar levels, leading to consistently high levels. The second cause is vascular disease in the lower limbs of the patient, including arteriosclerosis, with severe cases leading to occlusion and subsequent ulceration of the feet. The third reason is the presence of diabetic peripheral neuropathy in patients, which results in abnormal sensations or numbness in the feet. Many patients wearing new shoes or stepping on sharp objects inadvertently can lead to diabetic foot. The fourth cause is infection induced by patients who initially neglect minor foot injuries, or who improperly manage such injuries at home, leading to the development of diabetic foot. Therefore, we advise diabetics to maintain good control of their blood sugar and take timely measures to prevent diabetic foot.

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Gestational diabetes range

Gestational diabetes refers to abnormal blood sugar levels occurring during pregnancy. This term is used if the diagnosis is made during pregnancy, and does not include patients who were already diabetic before pregnancy, who are referred to as having diabetes concurrent with pregnancy. The criteria for diagnosing gestational diabetes are based on the results of the OGTT (Oral Glucose Tolerance Test) conducted between 24-28 weeks of pregnancy. According to the OGTT results, a fasting blood sugar level ≥ 5.1 mmol/L, a one-hour blood sugar level ≥ 10.0 mmol/L, or a two-hour blood sugar level ≥8.5 mmol/L, meeting any one of these criteria confirms a diagnosis of gestational diabetes.

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Key Points of Diabetic Foot Care

First, a daily foot examination is necessary, including the top, bottom, and toes. Carefully observe the skin's color, temperature, and moisture level, check for edema, skin lesions, and assess sensory and motor reflexes. Second, maintain a daily routine of soaking the feet in warm water. The water temperature should not exceed 40°C, with the soaking time ideally between 10 to 20 minutes. Third, regularly trim your toenails. Long toenails can easily break and damage the surrounding tissue, thus it is important for diabetic foot patients to regularly trim their nails. Fourth, the breathability of shoes and socks is important. It is advised not to wear sandals or slippers that expose the skin of the feet since exposed skin is more susceptible to injuries. Fifth, never walk barefoot. Sixth, avoid using electric blankets, hot water bottles, heating by the fire, and cupping therapy, to prevent burns on your feet. Seventh, maintain proper skin moisture. For patients with sweaty feet prone to excessive sweating, fungal infections may occur. It is recommended to wipe the spaces between toes with medical alcohol during foot baths, and to add a small amount of vinegar to the footbath water, as a bifunctional environment discourages fungal growth. Eighth, actively control blood sugar levels in diabetes. Ninth, maintain moderate exercise. Frequently elevate the affected limb to facilitate blood return and improve circulation in the lower limbs.

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Written by Li Hui Zhi
Endocrinology
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How is type 2 diabetes treated?

The treatment of type 2 diabetes includes the following aspects. First, dietary treatment is recommended, advising regular and quantitative meals three times a day, and avoiding late-night snacks and extra meals. Second, appropriate exercise. Third, self-monitoring of blood glucose; it is best to purchase a glucometer for home use and show the recorded blood glucose levels to the doctor during hospital visits. Fourth, diabetes education. Fifth, medication treatment, which includes oral medications and insulin therapy. It's important to visit an endocrinology specialist promptly to determine the most suitable medication under the guidance of a doctor.

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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.

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Gestational diabetes check at how many weeks?

Screening for gestational diabetes is generally recommended between 24 to 28 weeks of pregnancy, using a 75g glucose tolerance test to measure fasting blood glucose, blood glucose one hour after consuming glucose, and blood glucose two hours after consuming glucose. However, for pregnant women with high-risk factors, it is recommended to screen for blood glucose at their first prenatal visit. High-risk factors include women with a history of gestational diabetes, a history of delivering a large baby, obesity or polycystic ovary syndrome, those with a first-degree relative with a history of diabetes, positive fasting blood glucose or urinary glucose in early pregnancy, those who have had multiple unexplained miscarriages, fetal malformation, stillbirth history, and women who have given birth to newborns with respiratory distress syndrome. These women should all be screened for blood glucose at their first prenatal visit.