Diabetic Foot: Pathogenesis and Treatment Plan

Diabetic foot is a severe complication in diabetic patients caused by long-term hyperglycemia leading to neurological and vascular disorders of the lower limbs. It manifests as foot ulcers, infections, and deep tissue destruction, with severe cases even necessitating amputation.

Pathogenesis

The pathogenesis of diabetic foot mainly includes the following aspects:

1. Neuropathy: Chronic hyperglycemia leads to peripheral neuropathy, causing reduced or loss of sensation in the patient's feet, making them prone to injury and less perceptive, thereby leading to ulcers.
2. Vascular changes: Diabetes causes atherosclerosis of the lower limb arteries, resulting in arterial stenosis or occlusion, leading to insufficient blood flow to the feet, tissue ischemia, and hypoxia, affecting the healing of ulcers.
3. Infection: With reduced sensation in the feet, they are susceptible to external injuries and infections, and coupled with poor blood circulation, infections are difficult to control and may rapidly deteriorate.
4. Other factors: Include foot deformities, trauma, and inappropriate footwear, all of which can increase the risk of diabetic foot.

Preventive Measures

The key to preventing diabetic foot lies in the early identification and control of risk factors:

1. Regular examination: Conduct regular foot examinations, including assessments of skin, neurological, and vascular conditions of the feet.
2. Blood glucose control: Good blood glucose control can reduce the risk of diabetic foot.
3. Appropriate exercise: A moderate amount of exercise helps improve blood circulation in the lower limbs.
4. Foot care: Keep the feet clean and dry, avoid foot injuries, and wear suitable footwear.

Treatment Plan

The treatment of diabetic foot requires a comprehensive consideration of the patient's specific situation, including:

1. Internal medicine treatment: Control of blood glucose, blood pressure, and blood lipids, improvement of microcirculation, and the use of neurotrophic drugs.
2. Local debridement: For ulcers that have already formed, professional debridement is needed to remove necrotic tissue and promote the growth of granulation tissue.
3. Antibiotic treatment: For infected ulcers, appropriate antibiotics should be chosen based on the results of bacterial culture.
4. Surgical treatment: For severe vascular changes or ulcers, vascular reconstruction surgery or amputation may be necessary.
5. Rehabilitation therapy: Including physical therapy and functional exercises to help patients recover foot function.

Conclusion

Diabetic foot is a serious complication of diabetes that requires the joint efforts of patients, family members, and the medical team for prevention and treatment. Through early identification, active treatment, and good self-management, most diabetic feet can be effectively controlled to avoid serious consequences.

References

1. CDS2018: Professor Ran Xingwu's Interpretation of the Chinese Diabetic Foot Disease Prevention and Treatment Guidelines https://heart.dxy.cn/article/591018

2. Diabetic Foot Diagnosis and Treatment Guidelines - Dingxiang Garden http://heart.dxy.cn/article/79823

3. Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes (13) - Diagnosis and Treatment of Diabetic Foot - Dingxiang Garden http://endo.dxy.cn/article/22020

4. Chinese Diabetic Foot Diagnosis and Treatment Guidelines - yuntsg.com https://njguloulib.yuntsg.com/ueditor/jsp/upload/file/20200416/1587006441691068865.pdf

5. Chinese Diabetic Foot Prevention and Treatment Guidelines (2019 Edition) (I) - China Diabetes https://rs.yiigle.com/CN115791201902/1116403.htm