Diabetic foot - one of the most common and severe
complications of diabetes. Prolonged high glucose
in the blood vessels leading to shock and lower limb nerves
there is a disorder of innervation - neuropathy and / or blood supply -
angiopathy. Against the backdrop of the changed security forces patient
diabetes, minor foot trauma (corn, crack,
prick sloppy haircut nails, injury, etc.) can lead
the various manifestations of diabetic foot syndrome.
- trophic ulcers;
- chronic, nonhealing sores;
- cellulitis of the foot; osteomyelitis of the foot bones;
- gangrene of one, several,
finger portion or the entire foot.
All this increases the likelihood of high
lower limb amputations.
Diagnosis of diabetic foot
First, the surgeon identifies
disease, determines the degree and appoints the necessary examination
to determine the immediate cause complications (neuropathy, ischemia
- A blood test and biochemical urine test.
- Glycemic and glyukozurichesky profiles (patients during the day several times determined blood sugar and urine).
- X-ray of the foot in 2 projections (to detect bone lesions).
- Bacteriological examination (determined by the microbe that caused inflammation) to assign the appropriate antibiotic.
- Ultrasound patency of the main arteries of the lower extremities.
- The neurologist determines the character of neuropathy (tactile definition,
temperature, pain sensitivity, reflexes and degree of violations
of nerve impulses in the lower limbs - electromyography).
Treatment of diabetic foot
Based on the results of blood tests and urine endocrinologist conducts
correction of blood sugar levels. As a rule, the period of a stationary
treatment of diabetic foot, all patients were transferred to the introduction of
regular insulin doses adequate.
Depending on the symptoms and the degree of diabetic foot neuropathy prescribers alpha-lipoic acid.
If the diabetic foot struck the main vessels
(Macroangiopathy), consult a vascular surgeon
for the possibility of surgical correction of ischemia. at
the absence of such a possibility should be conservative therapy
diabetic foot prostanoids (vazaprostan, alprostadil)
heparinoid (sulodexide), desagregants (tromboass).
Depending on the symptoms of diabetic foot carried
complex treatment including surgery (in one or more
steps) and conservative (dressings with antiseptics
and medical wound dressings). Patients with diabetic foot are
Hyperbaric oxygen therapy course (in a hyperbaric chamber the patient breathes pure
oxygen at elevated pressure).