Avoid amputations: Diabetics should check their feet for skin defects daily

Avoid amputations: Diabetics should check their feet for skin defects daily

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Feet of people with diabetes need a lot of care

More and more diabetics live in Germany. Diabetes can lead to numerous complications, including a so-called diabetic foot syndrome, which can lead to long illnesses with surgical interventions and even amputation. People suffering from diabetes should therefore check their feet daily and take good care of them.

Illness can result in numerous complications

According to an analysis, around 7.6 million people in Germany are affected by diabetes. The disease can lead to numerous complications. Diabetes often causes diseases of the cardiovascular system over time. In addition, diabetics are at risk of developing a so-called diabetic foot syndrome - a late consequence of diabetes. Small injuries can quickly expand into large wounds with severe inflammation, which, if left untreated, can lead to long illnesses with surgical interventions and even amputation. Therefore, diabetic people should check their feet for skin defects every day and take great care in foot care.

Impaired wound healing

In people with diabetes, changes in the foot occur as a result of changes in the metabolism over the years due to the increased blood sugar level: nerves, blood vessels, muscles, ligaments and bones are affected.

As the German Society for Orthopedics and Trauma Surgery e. V. (DGOU) explains in a message that the feet quickly become dry and cracked and are therefore prone to injury.

Wound healing is impaired due to circulatory disorders. In addition, there is a loss of sensitivity to pain due to nerve damage (polyneuropathy): For example, a painful stone in the shoe is not perceived and can rub the foot sore.

"The lack of skin sensitivity must therefore be compensated for by a control look," explains Dr. Jörn Dohle, head of the DGOU section German Association for Foot and Ankle (D.A.F.).

Treat even minor injuries immediately

If there is a minor injury or inflammation on the foot, it should be treated immediately.

"Slight defects can quickly develop into chronic wounds if they are not treated early," warns D.A.F. expert Dr. Tanja Kostuj.

This would result in ulcers, for example, in which the surrounding tissue ignites and dies. As a result, amputation of the toe, a foot or an entire leg was not uncommon.

But many of these amputations can be avoided.

Lifelong need for rehabilitation

Health experts advise diabetics to always be careful with their feet.

“The early detection of abnormalities is crucial for a good healing. Therefore, diabetics should present the smallest skin cracks, injuries and pressure points on the foot to a specialist at an early stage, ”says Prof. Dr. Carsten Perka, Deputy President of the DGOU.

However, many patients with diabetic foot syndrome only go to the doctor if they have serious symptoms and are often referred to the specialist too late.

According to the experts, there are approximately 19,000 amputations of the upper and lower leg (major amputations) and 44,000 amputations of the foot in Germany every year - circulatory disorders are the cause in 43 percent of the cases, and diabetes mellitus in 39 percent of the cases.

Prof. Bernhard Greitemann, chairman of the DGOU section Association for Technical Orthopedics (VTO), draws attention to the serious consequences of a leg or foot amputation:

"Patients have a lifelong need for rehabilitation after an amputation - walking with a prosthesis must be learned anew."

This way, complications can be avoided

Prevention measures and early diagnosis or therapy are crucial for maintaining feet in diabetics.

Orthopedic surgeons and trauma surgeons therefore recommend the following measures:

Self-examination: Diabetics or their relatives should check the feet for injuries, pressure points and nail changes every day. In the event of damage, medical advice should be sought immediately to prevent inflammation from spreading.

Foot care: The feet should be washed and creamed daily. Caring for the toenails is also included, if necessary by a specialist. The stocking change and the disinfection of the shoes from the inside should be carried out every day.

Footwear: Diabetics should not wear too tight or abrasive footwear so that there are no pressure points or ulcers. The shoe should be big enough on the toes and should not have any seams on the inside. A soft, breathable leather and no or a soft front cap are advantageous. If there is already nerve damage (polyneuropathy) or misaligned feet, care should be taken to ensure that the foot is appropriately customized for diabetic soft footing.

Changing shoes: Diabetics should change their shoes more often to reduce pressure points.

Immediately to the doctor: Any swelling on the foot, the smallest damage to the skin or a fungal infection should be examined by a doctor.

Foot protection: Walking barefoot should be avoided entirely because of the risk of injury, especially if nerve damage (polyneuropathy) has already been identified, i.e. the pain stimulus fails as a natural protection against deeper injuries.

Presentation in a "diabetic foot clinic": In the case of already open and inflamed areas on the foot or pronounced diabetic foot syndrome, wound healing should be carried out quickly to counter amputation. (ad)

Author and source information

Video: Evaluation and Management of Diabetes-Related Foot Complications (July 2022).


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