Diabetic Foot syndrome
Introduction
Diabetes mellitus refers to a group of diseases that affect the way the body uses blood sugar (glucose). Glucose is an important source of energy for the cells that make up muscles and tissues and is also the primary fuel source for the brain. The underlying cause of diabetes varies depending on the type of diabetes affecting the patient.
An diabetic foot constitutes a modern pandemic which is associated with the continuous increase of diabetics worldwide. By 2050 one in seven people is expected to be diabetic, while 25% of these patients will develop diabetic foot. The fact that every 20 seconds a diabetic foot is amputated somewhere on the planet highlights how dramatic the situation is and how important prevention and early treatment of it are.
What is a diabetic foot syndrome? How should people with diabetes take care of themselves and how can they avoid serious complications such as amputation?
Proper foot care, regular check-ups and correct management of diabetes can prevent problems before they become dangerous. If you notice changes in the skin, wounds that do not heal or unusual pain, do not hesitate to seek medical advice. For more information you can watch the video.
The timely early diagnosis of the disease
is very important
for the good outcome of the condition in both stages of the disease.
What is a diabetic foot syndrome?
An diabetic foot is the sum of the complications of diabetes in the tissues of the foot. Elevated sugar levels cause hardening and dehydration of the skin, changes in joint architecture (Charcot foot), inflammation of the bones (osteomyelitis), loss of pain sensation due to destruction of nerve fibers (neuropathy) and most importantly blockage of the small arteries of the foot (diabetic angiopathy). Consequently, the diabetic foot is a condition caused by the presence of angiopathy or neuropathy, conditions that disrupt blood circulation, slowing down wound healing. This results in minor injuries persisting, leading to infections, ulcers and gangrene.
Diabetic Foot Syndrome: Symptoms
Symptoms of diabetic foot syndrome vary depending on the underlying cause. The most important factor is early recognition of warning signs. Common symptoms include:
- numbness, burning sensation, or tingling in the toes or sole of the foot
- dry, hardened skin often with cracks
- changes in nail texture or color
- small wounds that heal slowly
- discoloration of a toe (darkening), indicating reduced blood flow and possible gangrene
Early recognition of symptoms plays a critical role in preventing severe complications. Any wound in a diabetic foot should never be ignored.
Ποιες είναι οι επεμβατικές μέθοδοι χειρουργικής θεραπείας;
Treatment of Diabetic Foot Syndrome
There is not a single treatment option for the patient with diabetic foot, but a multidisciplinary approach by a specialized team of doctors. The patient with diabetic foot must be evaluated by a cardiologist, nephrologist and diabetologist in parallel with the vascular surgery assessment. Subsequently there should always follow a diagnostic angiography either with iodinated contrast agent (in patients with good renal function) or with carbon dioxide (in patients with renal insufficiency). Depending on the findings of the angiography and the results of the rest of the clinical examination, the best treatment is decided between the minimally invasive (endovascular) and open surgical method (bypass).
In our clinic, the full spectrum of the most complex vascular surgery conditions is performed through the modern Hybrid Clinic of the Athens Medical Center.
The role of the vascular surgeon
A Dr. Bisdas and the philosophy of our clinic holds one of the greatest experiences in Greece in the treatment of the diabetic foot with particularly low amputation rates. Our motto remains "NO TO AMPUTATION" and for this reason we have created a specialized team of doctors, nurses and podiatrists for the care of patients both during their hospitalization in the hospital and for post-operative home care. Furthermore our team offers the service of "SECOND OPINION" for patients who have been recommended amputation of the foot. In these patients we check whether all the necessary examinations have been performed that prove that a foot cannot be saved and in the event that it is technically feasible, we intervene to open the vessels and avoid major amputation. In a recent publication of ours, this strategy of ours led to more than 95% of patients avoiding amputation (Bisdas et al. Int J Low Extrem Wounds. 2022 Jun;21(2):174-181)!
Prevention and avoiding amputation
Amputation is not inevitable for patients with diabetic foot syndrome. Every patient with diabetic foot syndrome should undergo diagnostic angiography of the lower limbs before any decision for amputation is made. For this reason, seeking a second medical opinion, is extremely important before making any final decision. However, in advanced and neglected cases where irreversible tissue damage or septic shock has developed, amputation may become necessary. With proper prevention and care, these severe outcomes can often be avoided.
Prevention includes regular medical check-ups, good control of blood glucose levels, and early treatment of any foot problems.
Do not ignore the symptoms! Early diagnosis can save your foot! For comprehensive diagnosis and treatment, Get in Contact with our clinic!
Frequently Asked Questions (FAQs)
What is a diabetic foot syndrome?
Diabetic foot is a serious complication of diabetes that occurs when high blood sugar damages the nerves and blood vessels of the lower limbs. Neuropathy reduces pain sensation, while vascular disease decreases blood circulation. As a result, minor injuries may develop into serious wounds or ulcers.
What are the early symptoms of diabetic foot?
Early symptoms may include numbness or tingling in the feet, a burning sensation, dry skin, changes in skin color, and small wounds that do not heal easily. These signs indicate a risk of ulcer development.
How should a wound on a diabetic foot be treated?
Any wound on a diabetic foot should be considered a medical emergency and evaluated by a physician immediately. Patients should not attempt self-treatment. Medical evaluation is necessary for proper cleaning of the wound, antiseptic treatment, and possible antibiotic therapy. Early treatment significantly reduces the risk of infection and complications.
What happens if a diabetic foot becomes inflamed?
Inflammation in a diabetic foot is dangerous because it may progress to infection of the tissues or bones. Symptoms may include redness, swelling, pain, and discharge. Without prompt treatment, there is a high risk of gangrene and amputation.
What medications are used for diabetic foot?
Treatment depends on the severity of the condition and may include antibiotics to treat infections, medications that improve circulation, and strict control of blood sugar using antidiabetic medications or insulin. Proper glucose regulation is essential for wound healing.
Which doctors specialize in treating diabetic foot?
Diabetic foot care requires a multidisciplinary approach, involving diabetologists, vascular surgeons, orthopedic or plastic surgeons, and podiatrists. This collaborative approach ensures comprehensive treatment and prevention of complications.
How is diabetic foot treated?
The vascular surgeon plays a central role in the treatment of diabetic foot, focusing mainly on the restoration of blood circulation in the lower limbs. Through examinations he evaluates the condition of the vessels and, if he identifies stenoses or blockages, he can proceed with procedures such as balloon angioplasty/stent or surgical (by pass). The goal is the improvement of blood supply, which is of vital importance for wound healing and the avoidance of amputations.
