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 Li Hui Zhi
Endocrinology
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Early symptoms of type 2 diabetes

The typical symptoms of type 2 diabetes are referred to as "three excesses and one deficiency." The three excesses include excessive thirst and dry mouth, increased appetite with frequent hunger, and increased urination. The one deficiency refers to weight loss; these are the more typical symptoms. Some patients might often find out about their elevated blood sugar during routine health checks at work. Others may seek medical advice due to issues like skin itchiness or wounds that heal poorly after injury. Some might mainly experience numbness in their hands and feet, or blurred vision among other symptoms.

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Written by Li Hui Zhi
Endocrinology
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What to eat for diabetic foot

For patients with diabetic foot ulcers, first, their diet should control blood sugar. Foods with a high glycemic index like porridge, glutinous rice, and rice noodle rolls should be avoided. Additionally, sweet foods are also off-limits; it's important for meals to be regular and measured. Second, as patients with diabetic foot ulcers need nutrients for wound healing, they can eat foods high in protein such as eggs, fish, fish soup, and lean meats to promote wound healing. Third, if the patient also has high blood lipids, it's advisable to maintain a light diet and avoid greasy foods.

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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 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 Tang Zhuo
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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.