Leading to the risk factors of diabetic foot and diabetic foot follow-up frequency should be based on the type and extent of disease determined.
What is the pathogenesis of diabetic foot?
1, neuropathy is caused by sensory impairment caused by diabetic foot basis
Limb blood vessels and autonomic neuropathy in blood vessels weakened movement, local organizations, lowered immunity, minor trauma can cause infection, but
due to local sensory disturbances, small lesions can not be timely treatment, resulting in the rapid expansion of the wound. At the same time due to physical
sensory dysfunction, but also easy to cause scalding. Neuropathy can cause a small foot muscle atrophy, due to the long stretch muscles non-confrontational
form a claw-like toe and specifically the third, fourth and Toe〕. This deformity to make weight-bearing plantar metatarsal head as the anchor, due to
friction, there is the formation of the corpus callosum, vulnerable to infection, and penetrating ulcers, severe cases, spread to the bone near the bone
caused by inflammation. As the joint movements of deep sense of loss and reflection obstacles, so that the patient is not conscious of the circumstances,
some joint overload, loss of repeated trauma on the protective effect, so that the joints and articular surface of the rules has become very easy to fracture
, joint dislocation and subluxation, especially the metatarsophalangeal joint.
2, lower extremity ischemia occurred atherosclerosis leading to the foot, prompting diabetic foot may occur
After the lower extremities caused by arteriosclerosis occurred foot ischemia, especially in the toes, coupled with the small blood vessels and microvascular
disease, so that toe blood pressure, systemic blood pressure down to half or less. Patients often asleep at night due to toe pain to get up and walk a few
steps in order to alleviate the need. In some cases requiring a rapid increase blood circulation situations (such as trauma, infection, cold and hot, etc.)
can not be a corresponding increase in blood flow can cause gangrene, particularly toes staggering.
3, diabetic foot infections are caused by the fuse
Neuropathy and ischemic easily lead to local trauma, secondary to severe infection. In the minor trauma such as the foot of the pressure sores, toenail
trimming too short, athlete's foot can be caused by improper treatment of secondary infection. Plantar pressure overload in the area of the skin and
subcutaneous adipose tissue may be fibrous thickening, once the heel has been infected, easy to spread quickly to four weeks, ligament injuries can the
spread of infection, causing metatarsal osteomyelitis. The degree of ischemia occurs under wet, dry and mixed gangrene.
Leading to the risk factors of diabetic foot
(1) The duration of diabetes more than 10 years;
(2) Long-term blood glucose control is poor;
(3), wearing inappropriate shoes, foot health is poor;
(4) foot ulcer's past history;
(5), neuropathy symptoms (foot numbness, feeling of touch or pain diminished or disappeared), and (or) of ischemic vascular disease (exercise-induced calf
pain or fat cool);
(6) signs of neuropathy (foot fever, the skin does not sweat, muscle atrophy, eagle claw-like toes, pressure points, skin thickening, a good pulse, blood
filling sound), and (or) signs of peripheral vascular disease (foot-fat cool, shiny skin, thinner, pulse loss and subcutaneous tissue atrophy);
(7), diabetes and other chronic complications (severe renal failure or kidney transplant, it is obvious retinopathy);
(8) neurological and (or) vascular disease is not serious and there is a serious foot deformity;
(9) other risk factors (decreased visual acuity, affected the function of the orthopedic foot problems such as knee, hip or spinal arthritis, inappropriate
footwear;
(10) personal factors (socio-economic conditions of poor, elderly or living alone, refused treatment and care; smoking, drinking, etc.);
(11) delayed diagnosis of diabetes.
The frequency of follow-up of diabetic foot disease should be based on the type and extent of. For example, the plantar ulcers in patients with referral
should be ground, we could have a ~ 3 weeks review once; foot sensory loss in patients can return visit once every 3 months.
