Often, with such a complication of diabetes mellitus as diabetic damage to the lower extremities , the following terms are used: distal diabetic neuropathy , diabetic polyneuropathy (although this term is broader).
As in all organs, in the lower extremities there is a kind of “sugaring”, damage to blood vessels and nerves. This significantly reduces the sensitivity of the legs, and, as a result, increases the likelihood of foot trauma, the occurrence of foot ulcers, the development of gangrene and even amputation of the lower extremities. Sugaring of the nerves of the legs negatively affects their pain, temperature, tactile, vibration sensitivity. This lesion is called distal neuropathy in diabetes mellitus .
Doctors conducted studies of cases of severe complications from the lower extremities. These studies helped to identify the immediate causes of gangrene, and on their basis, develop clear rules for foot care. In those patients with initial lesions of the lower extremities, the application of these rules in practice made it possible to reduce the number of amputations by 80%. Therefore, in simple terms, the treatment of feet with diabetes should take place strictly according to the rules developed in the offices of ” diabetic foot “.
Most often, the following situation occurs: against the background of “sugaring”, the temperature, pain and tactile sensitivity of the legs decreases ( diabetic neuropathy ). Minor trauma, minor wound, abrasion goes unnoticed. She soon becomes infected and grows in size. An infected ulcer leads to an increase in blood sugar, which, in turn, has a negative effect on healing. If effective measures are not taken in time, this can lead to trophic ulcers in diabetes and gangrene of the lower extremities. The main preventive measure of such a situation is proper foot care for diabetes using specially developed means (for example, DIALINE, Diaultraderm). Also, to prevent the above complications, it is recommended to wear special socks for diabetic patients DIALINE.
The defeat of the lower extremities, depending on whether the vessels or nerves are more affected, can be divided into 2 groups:
I. Ischemic (angiopathic) foot – predominant vascular lesion
This condition is accompanied by the following symptoms:
- Skin cold to the touch on the legs and feet.
- Pale coloring of the skin of the feet. Also, the skin can be marbled / variegated.
- There is a lack of hair on the lower leg.
- Pain when walking (also called intermittent claudication). In advanced stages, pain can bother patients even at rest. Such ischemic pains are relieved only if the legs are lowered from the edge of the bed.
- The appearance of ulcerative defects along the edge of the foot.
- There may be a decrease in pulsation on the feet .
II. Neuropathic (neuropathic) foot – predominantly nerve damage
The main symptoms of this condition:
- The foot is hot or warm to the touch.
- Complaints of burning, stitching pains in the legs (mainly at night).
- A gradual decrease in the sensitivity of the lower extremities (tactile, vibration, pain, temperature), which eventually disappears completely. In this case, there is a risk of injury to the lower extremities.
- Horny skin on the feet, especially in areas of high pressure.
- Painless ulcerative defects on the feet in the areas of the foot support, as well as in the areas of hyperkeratosis.
Charcot’s foot (osteoarthropathy) is a type of neuropathic foot that is characterized by changes in its bone structures. This often causes the appearance of pronounced deformities, spontaneous fractures and even ulcerative defects in the foot.
If you find any of the signs of the lesions listed above, you should immediately visit the center or office “Diabetic Foot”. There will be a complete examination to determine the extent of the lesion.
It is important to remember that for any diabetic lesions of the lower extremities, including such as diabetic neuropathy, treatment should be carried out under the close supervision of a physician