Diabetic foot: an overview of information

The diabetic foot syndrome is a pathological condition in diabetes mellitus, characterized by damage to the skin, soft tissues, bones and joints and manifested by trophic ulcers, skin-joint changes and purulent-necrotic processes.

[1], [2], [3], [4], [5], [6],

Epidemiology of the diabetic foot

Diabetic foot occurs in 10-25% of patients with diabetes mellitus and is the leading cause of amputation of the lower extremities, which in patients with diabetes is 17-45 times more likely than in persons without a violation of carbohydrate metabolism. It is this factor that determines early disability and mortality in patients with diabetes mellitus.

[7], [8], [9], [10], [11], [12],

Causes and pathogenesis of diabetic foot syndrome

The main causes of the development of diabetic foot syndrome:

• peripheral neuropathy,    
• ischemia of the lower extremities;
• "Minor" trauma to the foot;
• deformation of the foot;
• infection.

Risk Factors for Diabetic Foot Syndrome:

• diabetic polyneuropathy at the stage of clinical manifestations;
• diseases of peripheral arteries of any origin (including diabetic microangiopathy);
• deformation of feet of any origin;
• marked decrease in visual acuity, blindness;
• diabetic nephropathy;
• lonely living of elderly patients;
• alcohol abuse;
• smoking.

The cause and pathogenesis of the diabetic foot

[13], [14], [15], [16], [17],

Clinical signs and symptoms of diabetic foot syndrome

Clinical features of the neuropathic and ischemic forms of the diabetic foot syndrome are shown in the table.

To address the issue of the need for antibiotic therapy, timely recognition of systemic and local signs of wound infection plays a significant role.

Systemic signs of a wounded infection:

• fever;
• intoxication;
• leukocytosis.

Symptoms of the diabetic foot

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Diagnosis of diabetic foot syndrome

Early diagnosis of initial signs of damage to the peripheral nervous system, vascular system, soft tissues and bone structures of the lower limbs is aimed at preventing amnestic in patients. Diabetes mellitus.

To conduct an initial diagnostic search, it is often sufficient to have a general clinical study and a minimal set of instrumental diagnostic methods that help determine - the state of peripheral innervation and the main arterial blood flow.

Diagnosis of the diabetic foot

[22], [23], [24], [25], [26], [27]

Treatment of diabetic foot syndrome

Principles of conservative treatment of diabetic foot syndrome:

• compensation for diabetes mellitus;
• antibiotic therapy.

Principles of prevention of diabetic foot syndrome

• treatment of patients;
• regular wearing of orthopedic shoes;
• regular removal of hyperkeratoses

The amount of necessary medical care depends on the stage of the disease. Treatment of patients at the I stage of the diabetic foot syndrome consists in the adequate treatment of the wound defect and the affected area of the foot. Patients with the IA stage require a more detailed examination to assess the state of the circulation. At the II stage of the diabetic foot syndrome, the appointment of antibiotic therapy, local treatment and discharge of the limb is shown. Patients with IV-V stages of diabetic foot syndrome require immediate hospitalization in a surgical hospital, complex conservative and surgical treatment.

Treatment of diabetic foot