The precursor of diabetic foot

Written by Lin Xiang Dong
Endocrinology
Updated on September 17, 2024
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Diabetic foot is commonly seen in patients who have had diabetes for over ten years, often due to poor blood sugar control and inadequate care. There are three factors that lead to diabetic foot. The first is vascular factors, often accompanied by arterial stenosis in both lower limbs, leading to blood supply disorders. The second is neuropathy, accompanied by peripheral neuropathy, insensitivity to temperature and pain, which makes it easy to suffer burns and external injuries to the foot. The third factor is the presence of an infectious trigger. When these three factors combine, the risk of diabetic foot becomes very high.

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Written by Yang Li
Endocrinology
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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.)

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Written by Li Hui Zhi
Endocrinology
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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.

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Written by Chen Kai
Endocrinology
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How to treat diabetic foot pain

Diabetic foot is a chronic complication of diabetes, characterized by arteriosclerosis, narrowing, and occlusion of the lower limb vessels, and peripheral neuropathy caused by multiple factors following diabetes. Treatment mainly involves improving circulation and nourishing nerves, including performing lower limb arterial ultrasound to assess the extent of vascular occlusion. When necessary, stenting or vascular recanalization can be performed, and treatments including stem cell therapy are also viable options. For pain, severe pain can generally be managed by vasodilation and symptomatic treatment.

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Written by Luo Han Ying
Endocrinology
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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.

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Written by Li Hui Zhi
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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.