Key Points of Diabetic Foot Care

Written by Zhao Xin Lan
Endocrinology
Updated on September 09, 2024
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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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Symptoms of gestational diabetes

Gestational diabetes refers to abnormal glucose tolerance that occurs during pregnancy. It usually involves only mild, asymptomatic hyperglycemia without the typical symptoms of diabetes such as dry mouth, excessive thirst, frequent urination, and weight loss. However, significant increases in blood sugar can lead to symptoms such as dry mouth, excessive thirst, frequent urination, and weight loss. It is important to be vigilant for gestational diabetes in patients who exhibit symptoms such as excessive amniotic fluid, a large fetus, or recurrent urinary tract infections. Therefore, it is generally recommended for pregnant patients to complete an OGTT (Oral Glucose Tolerance Test) by the 24th week of pregnancy to confirm whether they have gestational diabetes. After childbirth, blood sugar levels in women with gestational diabetes generally return to normal, but the risk of developing Type 2 diabetes in the future significantly increases. Therefore, patients with gestational diabetes should undergo diabetes screening 6 to 12 weeks postpartum and be monitored over the long term.

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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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How to treat diabetic foot?

Diabetic foot is one of the most severe complications of diabetes. It is caused by a combination of factors including peripheral vascular disease and diabetic peripheral neuropathy associated with diabetes. In such cases, treatment can involve internal medicine, interventional vascular treatment, and surgical treatment cooperatively managed by multiple vascular departments. Early treatment focuses on controlling blood sugar, improving circulation, and nourishing nerves. If ulcerations and skin breakdown have already occurred in the foot, further debridement and anti-infection treatments are necessary. It is essential to conduct an ultrasound of the lower limb vessels to assess for any vascular narrowing. If severe vascular occlusion occurs, vascular surgery may be needed to restore blood flow. In cases of severe diabetic foot with infection, surgical debridement or even amputation may be necessary. Thus, it is crucial to control blood sugar well in the early stages of diabetes to prevent these complications and potentially avoid the onset of diabetic foot.

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During pregnancy, if the pregnant woman has diabetes, it is essential to control blood sugar reasonably. Otherwise, high blood sugar can seriously affect both the fetus and the pregnant woman, and in severe cases, it can cause diabetic ketoacidosis in the pregnant woman and fetal death in utero. Diabetes in pregnant women can be intervened in the following ways: First, through dietary control, eat less sugary foods, such as sweets, pastries, and fruits. Second, it is necessary to be moderately active during pregnancy, taking a walk or maintaining 5,000 to 10,000 steps daily, which helps in the consumption of glucose in the body. Third, if the above two methods are ineffective, insulin should be used to control diabetes.

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Diabetic foot ulcer precursor

Diabetic foot, as we discuss in medical terms, refers to patients with a history of diabetes who, due to poor blood sugar control, experience various complications such as the narrowing of arteries in the lower limbs, insufficient blood and oxygen supply, and neuropathy, which results in insensitivity to temperature and pain, making them prone to burns or other injuries. Additionally, diabetic patients have compromised immune systems, making them susceptible to infections. When these three factors combine, it easily leads to diabetic foot, which is also the precursor to what is colloquially known as "rotten foot" in diabetes.