Uncle Zhang, 78 years old, suffers from diabetes for more than 220 years. He was admitted to the hospital because "the pain and warm feeling of the left calf subsided, and his left foot had a dark skin size of broad beans and local pus flowed in 3 months."
Family members complained: 3 months ago, Mr. Zhang washed his feet at home. Because he did not pay attention to the water temperature, the water temperature was hot, and his left toe was burned. Then, the skin of the toe gradually became dark and a light yellow liquid flowed out of . After discovering it, he was sent to a local hospital for treatment and was admitted to the hospital for blood sugar check: 22.1mmol/L.
Previous medical history: Correction of cerebral infarction for more than 10 years, and now I have poor answers to questions and poor awareness.
Laboratory assisted test results: Number of white blood cells: 23.98*109/L; Number of neutrophils: 21.82*109/L; neutrophil ratio: 91.0%; C-reactive protein : 300ng/L.
Diagnostic results: , diabetes Type 2 diabetes foot with acute infection; 2. Diabetic foot gangrene; 3. Sequelae of cerebral infarction;
After admission, the doctor improved a series of examinations for Mr. Zhang , which clarified Mr. Zhang's diabetic foot diabetic foot During the diagnosis of gangrene, it was found that Mr. Zhang’s left toe had been necroticated by most of the . The doctor told Mr. Zhang and his family that amputation might be needed.
Because of a small scald, it may lead to amputation. Diabetic foot actually brings such a terrible posterior popliteal. Let’s get to know diabetic foot together.
1. What is diabetic foot
Before we know diabetic foot, we must first understand what is diabetes. Diabetes refers to a group of metabolic diseases caused by the secretion and/or defects of insulin and the main characteristics of chronic blood sugar levels. They are characterized by drinking, urinary, weight loss, urine sugar and blood sugar increase. , belongs to the category of "diagnosis" in traditional Chinese medicine.
Diabetes seriously affects individuals' quality of life and brings great burden to individuals and families. With the development of the economy and society, diabetes has become a common disease. According to the International Diabetes Federation report, China is a diabetes in the world In the country with the most patients, according to statistics, nearly 114 million adults with diabetes are diabetics, which has accounted for 24% of the total number of diabetes patients worldwide.
If we know diabetes, it will be easy for us to know diabetic feet. In life, we often call diabetic foot "old legs".
According to the "Interpretation of the Chinese Diabetes Foot Diagnosis and Treatment Guidelines", we currently believe that diabetic foot refers to diabetic peripheral nerve lesions that are combined with diabetes and various vascular lesions of diabetes on the basis of diabetes. Lower limb infection, ulcer formation and/or deep tissue damage caused by the influence of causes.
Diabetic foot is a chronic complication of diabetes, and it is also the most serious and most cost-effective chronic complication of diabetes. It seriously affects the health and quality of life of diabetic patients. If diabetic foot occurs, it does not obtain Timely and effective diagnosis and treatment will lead to amputation and even life-threatening.
2. These 4 signals appear on the feet may be that diabetic foot is coming
According to the "Interpretation of the Chinese Diabetic Foot Diagnosis and Treatment Guidelines", 4% to 10% of type 2 diabetes patients have diabetic foot, so as an ordinary person How should people judge whether they have diabetic foot? If you have diabetes, when the following four signals appear on your legs, it may be that the diabetic foot is coming.
. Esthetic abnormalities in the legs
One of the basic lesions of the diabetic foot is the lesions of the peripheral nerves of diabetes. When an abnormality in the nerves of the lower limbs will affect the sensation of the lower limbs, including the perception of pain, temperature, pressure, etc., so, Most patients with diabetic foot will experience sensation abnormalities in the lower limbs. In the early stage, it is mainly manifested as decreased sensation in the lower limbs, such as wearing socks, numbness in the distal lower limbs, pain in the lower limbs, Cold in the lower limbs , unknown causes of the lower limbs at night If pain continues to develop, intermittent claudication will even occur. When there is abnormal sensation of lower limbs, everyone needs to pay attention. At this time, you should go to the hospital to actively control blood sugar and delay the further development of nerve lesions.
Second, abnormal temperature occurs on the legs
abnormal temperature occurs on the legs, which is also one of the manifestations of diabetic foot. The abnormal temperature of the legs includes not only the feeling of coldness or heat in the legs, but also the decrease or increase of the local skin temperature in the legs. If the local skin of the legs is elevated, accompanied by redness and swelling, or black patches , ulceration, etc. , which needs special attention, because this may indicate infection, which is very dangerous, and you must go to the hospital as soon as possible.
. Local skin color changes occur on the legs
Diabetic vascular disease is another basic lesion that occurs in the diabetic foot. Due to long-term poor blood sugar control, the blood vessels, especially the systemic middle arteries, become thicker and narrower. Because these arteries become narrower or even completely blocked, the tissues supplied by these arteries will be lacking. Blood, even "infarction".
When diabetic patients have ischemia in their legs, the color of the local skin will change. If the blood supply to the local skin is not improved for a long time, it will be accompanied by pigmentation and darkening of the skin. This is not a good phenomenon , If there is another small rupture at this time, it will be very easy to get infection, and we often call diabetic foot gangrene. If the treatment is not done in time, you can only be amputated.
, ulceration, infection, gangrene on the legs
When diabetic patients experience ulceration, infection, gangrene on the lower limbs, this is likely to indicate that they are diabetic foot, and the condition is relatively serious and dangerous. Compared with normal people, diabetes is Patients are more likely to develop infections, and it is more difficult to control infections in patients with diabetes.
Under normal circumstances, if our skin has small ruptures, it is not easy to get infected. However, for diabetic patients, if there are small ruptures in the skin, it is easy to get infected. Therefore, when diabetic patients have ulcers on their legs, We must pay attention to , go to the hospital in a timely manner, prevent infection, and promptly cut off the trend of developing from diabetic foot to diabetic foot gangrene.
If the above four manifestations occur, you must pay special attention to whether there is diabetic foot. These four phenomena are four common signals for diabetic foot lesions, which often indicate the presence of diabetic foot lesions.
If the above symptoms occur, you need to go to the hospital as soon as possible. Now the hospital has many examinations for diabetic foot that can achieve "early detection, early diagnosis, and early treatment", including: 10g nylon silk examination, nerve conduction speed examination, ankle Artery- brachial artery blood pressure ratio examination, etc.
3. Prevent diabetic foot, you can do this in daily life
The key to preventing diabetic foot is to control blood sugar. Long-term high blood sugar level status is the fundamental reason for the occurrence and development of diabetic foot. To prevent diabetic foot, the fundamental problem is to strictly control blood sugar. , Diabetic patients should monitor their blood sugar regularly and take hypoglycemic drugs strictly according to the doctor's instructions.
At the same time, diabetic patients should mainly focus on low-fat, low-sugar, easy-to-digest, vitamin-rich light foods, eat less and more meals a day, and avoid eating high-fat foods, such as nuts, fried dough sticks, pancakes, etc.
In daily life, Appropriate exercise can improve the long-term prognosis of diabetic patients. Diabetic patients can perform calves and foot exercises for 30 to 60 minutes every day, such as walking, jogging, leg swinging, etc. On the basis of strict blood sugar control and supplemented by lifestyle regulation, it can effectively prevent the occurrence and development of diabetic foot.
The reason why diabetic foot seriously affects the health and quality of life of diabetic patients is that diabetic foot lesions are very prone to diabetic gangrene. Once diabetic gangrene occurs, this often means that part of the gangrene is repeatedly infected and requires frequent hospitalization or even amputation. , and one amputation may not be the end point, and even multiple amputations are required to be performed on the limbs with diabetes gangrene. Therefore, it is particularly important for patients with diabetic foot to prevent diabetic gangrene.
"A thousand-mile dike, corruption in an ant hole". Many minor accidents in life may lead to further development of diabetic foot into diabetic gangrene, so diabetic friends, especially patients with diabetic foot, should pay special attention to the details in life, such as "diabetic foot" Prevention and Nursing Progress pointed out:
1. The best water temperature when washing feet is 37~39℃. The time for washing feet should be controlled at 5~10 minutes to avoid adding thorns when washing feet. Toenails to protect the skin of the feet;
2. Trim toenails should not be too short, as it will easily damage the toes, and the edges of the toenails should be kept flat and smooth;
3. Avoid walking in the dark and avoid obstacles. Prevent the foot from hitting;
4. Avoid the foot massage with greater strength. Gentle massage can promote blood circulation in the foot and improve diabetic foot lesions, but the foot massage with greater strength may damage the skin. Causes gynecomastia; these are small details in daily life to avoid damage to the feet.
In the "Expert Consensus on the Prevention and Treatment of Diabetic Foot with Multidisciplinary Cooperation", it is also pointed out that suitable shoes can avoid diabetic foot damage and develop into diabetic gangrene: Diabetic patients can choose the shoe material is soft leather material and the toe is wide and deep Shoes, or other shoes that can reduce stress; secondly, pay attention to keeping warm in winter, prevent frostbite, and prevent foot damage, which is the best, most economical and easiest way to avoid diabetic foot gangrene.
The above case Mr. Zhang in the foot washing temperature was too hot, which burned the skin of his feet, and the local skin became black and ulcerated. He and his family did not pay attention to it, and eventually developed into diabetic foot gangrene. In the future, Mr. Zhang's life may only be able to live in a wheelchair or under a crutch.
In clinical practice, many patients with diabetic foot were repeatedly hospitalized because of scalds while washing their feet, and eventually developed into amputation. Therefore, for our health and life, the majority of diabetics should pay attention to the "four signals" when diabetic foot comes. Timely medical treatment delays the occurrence and development of diabetic foot and prevents the occurrence of gangrene of diabetic foot.
References:
[1] Zhao Chenxu, Zhou Huimin. Interpretation of "China's Guide to Diagnosis and Treatment of Diabetes Foot". Journal of Clinicians, 2021, 49(12): 1405-1408.
[2] Li Junli, Wang Ruijie, Ren Meiling. Prevention and nursing progress of diabetic foot. Corps Medicine, 2021, 19(04): 72-74.
[3] Dai Weiwei, Zhou Qiuhong. "Expert Consensus on the Prevention and Treatment of Diabetic Foot under Multidisciplinary Cooperation (2020 Edition)" (Prevention Section ) Interpretation. Practical Geriatric Medicine , 2022, 36(06): 645-648.
