Diabetic foot ulcer precursor

Written by Lin Xiang Dong
Endocrinology
Updated on September 21, 2024
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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.

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Written by Lin Xiang Dong
Endocrinology
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Care of diabetic foot

The care of diabetic foot is very important. In our daily life, we need to do the following aspects. First, regularly wash and check both feet. During washing, the water temperature should not be too high. Also, keep the skin moist to prevent it from drying and cracking. Second, choose suitable shoes and socks, preferably loose-fitting to avoid tightness. Third, be careful when trimming toenails, making sure not to damage the skin of the feet. If there are any sores, go to the hospital immediately for treatment. Fourth, avoid using corrosive chemicals on the feet.

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Written by Lin Xiang Dong
Endocrinology
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How to test for diabetes?

The examination for diabetes primarily involves assessment based on symptoms and measuring blood glucose levels through a venous sample. Typical clinical symptoms of diabetes include "three more and one less"; where "three more" refers to dry mouth, increased thirst, and frequent urination, and "one less" refers to weight loss. Thus, generally, when these symptoms are observed, there is an awareness of the possibility of diabetes. Subsequently, one should consult a hospital for further tests, which usually include urine testing and venous blood extraction. For diabetic patients, the glucose level in routine urine tests will significantly increase. Another measure is the direct measurement of blood glucose through venous blood. A fasting blood glucose level of ≥7.0 mmol/L, or a two-hour glucose level of ≥11.1 mmol/L post-OGTT, or a random blood glucose level of ≥11.1 mmol/L, meeting any one of these conditions, combined with the symptoms of diabetes, can diagnose the disease.

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Written by Zhang Lu
Obstetrics
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How to Control Gestational Diabetes

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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Written by Zhao Dan
Orthopedics
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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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Written by Wang Shuai
Urology
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Can frequent urination be diabetes?

If the amount of urine increases, the first thing to consider is the possibility of diabetes. In this case, a routine urine test will reveal a significant increase in urinary glucose. If a blood test for blood glucose is performed, an increase in blood glucose will also be found. For this situation, it is necessary to go to the hospital's endocrinology department for hypoglycemic treatment in a timely manner. Secondly, diabetes insipidus should be considered, which also causes an increase in urine volume, and the patient will have obvious thirst. Routine urine tests find that blood sugar in the urine is not high, the specific gravity of urine will initially decrease, and the patient's daily urine output will exceed 2500 milliliters, even reaching more than 4000 milliliters.