To prevent diabetic foot, attention must be paid to reducing individual risk factors. Behavioral risk factors Unsuitable footwear (pressure points). Walking barefoot Objects in the shoes Lack of / inadequate training Lack of compliance Other risk factors Fall/accident It is essential to observe the following preventive measures: Regular examinations of the feet and footwear Foot … Diabetic Foot: Prevention
The following symptoms and complaints may indicate diabetic foot: In diabetic neuropathy (nerve damage) – diabetic polyneuropathy – blood flow to the foot is intact. However, due to paralysis of the foot muscles, there is an incorrect load on the foot. This is manifested in the progressive sinking of the metatarsalia (metatarsal bones) in the … Diabetic Foot: Symptoms, Complaints, Signs
Pathogenesis (development of disease) Causally, ischemia (reduced blood flow), neuropathy (generic term for diseases of the peripheral nerves that do not have a traumatic cause), and infection (in this case, concomitant infection) play a central role. Furthermore, hyperglycemic status (hyperglycemia) plays a role in inducing a disturbance of the wound healing cascade. Approximately 50% of … Diabetic Foot: Causes
Notice: The most important measures are metabolic optimization and treatment of internal diseases and infection control. General measures Any concomitant medical conditions should be carefully monitored and treated. Blood pressure should be optimally adjusted. Blood lipids should be controlled and brought to a low level if necessary. Nicotine restriction (refrain from tobacco use). Limited alcohol … Diabetic Foot: Therapy
Notice: The most important measures are metabolic optimization and treatment of internal diseases and infection control. The following measures should be performed/observed in the presence of diabetic foot: Local wound treatment: wound debridement of avital tissue (wound toilet, i.e., removal of dead tissue); in this context, the so-called “moist wound treatment” has been established as … Diabetic Foot: Surgical Therapy
Medical history (history of illness) represents an important component in the diagnosis of diabetic foot. Family history Is there frequent diabetes mellitus (diabetes) in your family? Social history What is your profession? Current medical history/systemic history (somatic and psychological complaints). Are you experiencing pain? If yes, when does the pain occur? Where is the pain … Diabetic Foot: Medical History
Skin and subcutaneous (L00-L99). Decubital ulcers (pressure ulcers) associated with immobilization. Ulcus cruris venosum – lower leg ulcer, which is caused by venous insufficiency. Cardiovascular system (I00-I99) Angiodysplasia (malformations of arteries, veins, or lymphatic vessels). Lymphatic drainage disorders Peripheral arterial occlusive disease (pAVK) – progressive narrowing or occlusion of the arteries supplying the arms / … Diabetic Foot: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by a diabetic foot: Skin and subcutaneous (L00-L99). Wound healing disorders Musculoskeletal system and connective tissue (M00-M99). Charcot foot (diabetic neuro-osteoarthropathy; disease of the foot in which bones break rapidly without the affected person feeling pain; 95% percent of all affected … Diabetic Foot: Secondary Diseases
Classification according to Wagner Wagner stage Description 0 No lesion (injury) possibly foot deformity or cellulitis (acute skin infection caused by bacteria) 1 Superficial ulceration (ulcerations) 2 Deep ulcer, extending to joint capsule, tendons, or bone 3 Deep ulcer, with abscess, osteomyelitis (bone marrow inflammation), or infection 4 Limited necrosis (tissue damage due to death … Diabetic Foot: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height. Inspection (viewing) of skin/foot; if diabetic ulcers are present, they should not only be visually assessed but also explored with the aid of probing [involvement of tendons? and bone/osteomyelitis (bone marrow inflammation)?] … Diabetic Foot: Examination
1st order laboratory parameters – obligatory laboratory tests. Small blood count Inflammatory parameters – CRP (C-reactive protein). Fasting glucose (fasting blood sugar) HbA1c (long-term blood glucose value) Laboratory parameters 2nd order – depending on the results of the history, physical examination and the obligatory laboratory parameters – for differential diagnostic clarification. Bacteriology – blood cultures, … Diabetic Foot: Lab Test
Obligatory medical device diagnostics. Arterial occlusion pressure over the dorsalis pedis artery/posterior tibial artery. Ankle-brachial index (ABI; examination method that can describe the risk of cardiovascular disease) – The test is considered highly specific and sensitive for detecting peripheral arterial occlusive disease (PAVD). Doppler sonography (ultrasound examination that can dynamically visualize fluid flows (especially blood … Diabetic Foot: Diagnostic Tests