Care for diabetic foot

Written by Yang Li
Endocrinology
Updated on September 04, 2024
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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.

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How to reduce swelling in diabetic foot

How to reduce swelling in diabetic foot depends on the condition of the swelling. If the swelling is due to a wound on the diabetic foot causing localized redness and swelling, this condition needs anti-infective treatment. It is recommended to culture the wound secretion and choose a sensitive antibiotic; if the swelling is diffuse in the foot, it is also recommended to perform an ultrasound of the lower limb vessels, including arteries and veins. If this indicates poor venous return in the lower limbs or venous thrombosis, treatment to prevent thrombosis and improve venous return should also be added.

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Prevention of Gestational Diabetes

The prevention of gestational diabetes mainly focuses on diet and exercise. First, weigh yourself every morning to monitor weight changes during pregnancy, as excessive weight gain can increase the risk of gestational diabetes. Second, maintain a healthy and balanced diet that is low in fat and calories, and high in fiber and protein, avoiding excessive consumption of high-sugar foods. Third, regularly engage in exercises suitable for pregnancy. Fourth, keep a regular routine. Finally, closely monitor the fetus.

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Gestational diabetes standards

Before addressing this question, let's first clarify another concept: if diabetes is diagnosed before pregnancy, this is referred to as pre-existing diabetes in pregnancy, which is different from gestational diabetes. Gestational diabetes refers to cases where there is no pre-existing diabetes diagnosis before pregnancy, but abnormal blood glucose levels are detected after becoming pregnant. Generally, a glucose screening test is conducted between the 24th and 28th weeks of pregnancy. Currently in China, there are two approaches: the one-step and the two-step methods. The one-step method involves a direct 75-gram oral glucose tolerance test. However, most of China uses the two-step method, which starts with a 50-gram glucose challenge test. If the blood glucose level one hour after eating is greater than or equal to 7.8 mmol/L, a 75-gram oral glucose tolerance test is recommended. For the 75-gram glucose test, the fasting blood glucose level should generally be less than or equal to 5.6 mmol/L, one hour post-glucose intake should be 10.3 mmol/L, two hours post-glucose should be 8.6 mmol/L, and three hours post-glucose should be 6.7 mmol/L. If two or more of these values exceed the diagnostic criteria, gestational diabetes can be diagnosed. If only one value is abnormal, impaired glucose tolerance can be diagnosed. It is recommended that anyone who experiences abnormal blood glucose levels during pregnancy undergo another 75-gram oral glucose tolerance test six months post-pregnancy to determine if blood glucose levels are still abnormal and whether treatment should continue.

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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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Diabetic foot ulcer precursors

Diabetic foot, also known as diabetic foot disease, is a very serious complication among endocrine disorders in diabetes, with the most severe consequence being foot ulceration that cannot heal, leading to amputation, and even causing sepsis. Diabetic foot does not occur without reason; there are many warning signs before its occurrence. For example, the affected foot feels cold, it is painful to walk, and there are abnormal sensations. These signs are actually telling you that the blood vessels and nerves in the foot are already affected. Once any abnormal sensation is noticed, it is essential to seek medical attention at a hospital, and it is crucial to provide early and proactive treatment to nourish the nerves and improve circulation in order to prevent diabetic foot.