1999 WHO definition of the diabetic foot: neuropathy in diabetic patients due to the merger and all kinds of varying degrees of lower extremity peripheral vascular disease caused by infection, ulcer formation and (or) deep tissue damage.
Internal
Sustained high blood sugar is too high blood sugar easily lead to hypercoagulability, promoting the formation of lower limb atherosclerosis, is diabetic foot occurred in an extremely important factor. As a long-term blood glucose control are not satisfied, abnormal glucose metabolism caused by lipid metabolism disorders, body parts prone to major blood vessels and capillaries of the pathological changes leading to diabetic foot.
Diabetic patients with chronic vascular disease because the body continues to remain high blood sugar and protein non-enzymatic glycosylation status, lipid metabolism disorders, high blood viscosity, hypercoagulability, as well as age-related arteriosclerosis and many other factors that diabetic patients with lower extremity arterial vascular disease-prone , wall thickening, stenosis, and capillary and micro-circulation are also different levels of obstacles to the patient's lower extremities caused by hardening of the arteries and block blood vessel thrombosis, while micro-vascular occlusion foot, so that lower limb perfusion flow reduction in acral blood circulation disorder, local tissue hypoxia and inadequate supply of nutrients appeared lower extremity pain, paresthesia, and intermittent claudication, severe ulcers caused by insufficient blood supply can, limb gangrene.
Diabetic Neuropathy Diabetic peripheral neuropathy can cause limb of the weakening or loss of protective sensation, and changes in foot biomechanics, so that the lack of foot protection against harmful stimuli and thus vulnerable to damage caused by mechanical or temperature; autonomic neuropathy also the formation of diabetic foot related to autonomic neuropathy caused by sweat secretion of obstacles, can reduce the flexibility of skin, leading to dry skin, chapped and infection. Once the lower limb or foot skin damaged, the above-mentioned pathophysiological changes also difficult to repair the wound, infection difficult to control and finally the development of foot ulceration and even amputation.
Age of diabetic foot to occur in "40-year-old patient, and increased with age while the increase. Some studies reported that age was an independent occurrence of diabetic foot risk factors. Its possible causes: ① elderly patients with diabetes longer duration, higher incidence of atherosclerosis, hormone levels change; ② organizations of older persons metabolic rate, repair a reduced ability to extend the healing time after injury; ③ diabetic neuropathy increased with age.
The occurrence of diabetic foot sex and gender have a certain relationship. Internal documents suggest that the incidence of diabetic foot more men than women, analysis of the reasons may be estrogen to protect the role of blood vessels and thus opportunities for physical size of the vascular lesions were reduced in women with diabetes.
External
Infection in diabetic foot gangrene infection is an important predisposing factor. The main reason is the low capacity of anti-infection in patients with diabetes, in the case of limb ischemia and hypoxia, bacteria can easily invade, resulting in severe infection organization.
Physical injury to any minor injury can cause foot ulcers or infection, and sometimes even require amputation. Most patients with diabetic foot have different forms of tissue damage, such as burns, frostbite, scratches, abrasions, grinding damage, repair a broken foot, bumps, manicure injury after injury leading to diabetic foot infections is undoubtedly a risk factor can not be ignored.
In patients with diabetic foot with a male majority, old age, longer duration, low level of education, low income and the complications of diabetes, and cardiovascular risk factors, many features. Should be pointed out that in the survey years, resulting in the incentives of diabetic foot ulcers account for physical factors "3 / 4. These factors, in particular, burns and wearing inappropriate footwear, as well as the damage caused by improper nail trimming is entirely avoidable.
