1. What Is Diabetic Foot Disease (DFD)?
Diabetic foot disease (DFD) is one of the common complications of diabetes, which can cause serious consequences, diminishing the patient's quality of life, and even leading to death.
Each year, the number of diagnosed diabetes cases continues to rise, and along with it, the rate of diabetic foot ulcers has also increased significantly. It is estimated that about 15%-25% of diabetic patients are at risk of developing foot ulcers. Although this condition can occur at any age, it is most common in people aged 45 and older.
In terms of anatomical damage, diabetic foot is considered a complex injury that affects the skin, muscle, and even bone. The main cause stems from peripheral nerve damage, reduced blood circulation, and may or may not be accompanied by infection in the foot.
According to the World Health Organization's (WHO) 1995 definition, diabetic foot is a "clinical syndrome characterized by nerve damage, vascular disorders, and infection in the foot."
2. Signs of Diabetic Foot
Diabetic foot complications usually begin silently and progress quietly. For this reason, people with diabetes need to pay close attention to abnormal signs in their feet from the earliest stage to allow for timely intervention.
Below are some warning symptoms of the risk of diabetic foot complications:
A feeling of numbness or loss of sensation in the feet, as if wearing socks, with an inability to feel pain or temperature changes (hot or cold).
Being prone to loss of balance when the eyes are closed.
A burning sensation, sharp stinging pain like pins and needles or ants crawling/biting, or increased sensitivity to touch.
Changes in the color of the skin on the feet.
Skin temperature on the feet may be higher or lower than normal.
Swelling of the foot or ankle accompanied by pain.
Open wounds on the feet that are slow to heal or show signs of oozing.
Ingrown toenails or fungal infection.
Calluses or dry, cracked skin on the heels.
Persistent foot odor despite proper hygiene.
The big toe tending to deviate toward the smaller toes.
One or more small toes becoming abnormally curled, resulting in hammer toes.
As soon as any of the above symptoms are noticed, diabetic patients should promptly inform their doctor for advice and appropriate intervention.
3. What Negative Effects Does Diabetic Foot Disease Cause?
Diabetic foot complications can cause many serious consequences, affecting overall health and quality of life. In addition to causing pain and discomfort, this condition also reduces mobility and negatively affects other organs in the body.
Among foot-related complications, foot ulcers are the most common condition experienced by diabetic patients. If not well controlled, diabetic foot damage can lead to tissue necrosis, and may even require amputation to prevent the risk of spreading infection.
Statistics show that "more than 30% of foot ulcer cases are related to diabetes complications." When blood flow to the feet is severely reduced without being detected and treated in time, the risk of necrosis increases, making partial amputation difficult to avoid. This is one of the most dangerous complications of diabetes affecting the feet, requiring special attention from both patients and the medical team.
4. What Steps Should Be Taken to Prevent "Diabetic Foot"?
4.1. General measures to prevent diabetic foot complications
Maintain a scientific diet suitable for diabetic patients.
Increase physical activity with appropriate exercises.
Use medication as directed by your doctor and have regular foot check-ups.
Monitor blood glucose levels daily for better disease control.
4.2. Foot care measures for diabetic patients
Keep the hands and feet clean, and regularly check for early signs of abnormalities such as cracked skin, blisters, or newly formed calluses.
Wash feet with clean water and mild soap, and dry with a soft towel, especially between the toes.
Choose appropriate footwear that provides good foot protection and reduces the risk of injury.
Avoid smoking and eliminate habits that negatively affect health.
If numbness or foot pain occurs and diabetic complications are suspected, go to a medical facility for immediate examination and follow the doctor's treatment instructions.
4.3. Things to avoid to protect the feet
Do not walk barefoot or wear shoes that are too tight, and avoid cutting toenails incorrectly.
Do not self-treat calluses or ulcers, or use medication without a doctor's prescription.
Avoid soaking the feet in water that is too hot, or water mixed with leaves or herbs without guidance from a medical professional.
Do not use any treatment method for the feet without consulting a doctor.
Controlling and treating diabetic foot complications is a complex process that requires close cooperation between patients and doctors. Following proper care measures helps reduce the risk of infection, necrosis, and amputation.
5. How Is Diabetic Foot Disease Managed?
From the perspective of pathophysiology, clinical practice, psychology, and sociology, diabetic foot disease is closely related to many different specialties, including: Endocrinology, Infectious Diseases, Vascular Surgery, Orthopedics - Rehabilitation, Diagnostic Imaging, Nursing Care, and Psychological Counseling...
Therefore, effective management of diabetic foot disease requires multidisciplinary coordination to ensure a comprehensive and optimal treatment strategy for the patient.
5.1. Good control of metabolic disorders
Elevated blood glucose
Reduced albumin
Impaired heart and kidney function
Blood lipid disorders
Anemia
Electrolyte imbalance
5.2. Monitoring signs of infection
Assess the causative agent of infection through clinical examination or microbiological testing to determine the extent of foot damage, in order to select an appropriate antibiotic regimen for treatment.
Review the patient's overall health status and screen for accompanying conditions to determine the optimal treatment direction.
5.3. Treating foot ulcers according to severity
Mild foot ulcers:
Mainly caused by common bacteria such as Staphylococcus aureus and beta-hemolytic Streptococcus.
Recommended antibiotics include the penicillin group (dicloxacillin, cloxacillin, flucloxacillin) or first-generation cephalosporins (cephalexin).
If the patient is at risk of methicillin-resistant Staphylococcus aureus (MRSA) infection, antibiotics such as linezolid, trimethoprim-sulfamethoxazole, or doxycycline may be considered.
Moderate foot ulcers:
Usually caused by gram-positive cocci and aerobic and anaerobic gram-negative bacilli.
Appropriate antibiotics in this case include the fluoroquinolone group (ciprofloxacin, levofloxacin, moxifloxacin), which may be combined with clindamycin or penicillin to effectively control the infection.
Severe foot ulcers:
This is a dangerous condition requiring urgent treatment with intravenous antibiotics.
Treatment options usually include carbapenems (imipenem-cilastatin, meropenem) or antipseudomonal penicillins combined with beta-lactamase inhibitors (piperacillin-tazobactam) to control severe infection.
5.4. Wound care
Perform incision and drainage and remove necrotic tissue.
Control wound exudate.
Maintain tissue growth.
Ensure the wound healing process proceeds smoothly.
Protect the wound to prevent the risk of infection.
5.5. Assessing the risk of amputation
Factors that increase the risk of amputation in diabetic patients include:
Peripheral neuropathy
Peripheral vascular disease
Severe infection
History of recurrent foot ulcers
Foot deformity
Foot injury
Charcot foot syndrome
Impaired vision
Poor blood glucose control
Older age
Gender and racial factors
5.6. Amputation
This is the last treatment option when other measures are ineffective. Doctors indicate amputation in the following cases:
Severe foot infection that threatens the patient's life.
Secondary vascular occlusion causing foot necrosis that cannot be revascularized.
Severe osteomyelitis that cannot be recovered.
5.7. Offloading pressure from the ulcer
The goal of this method is to reduce pressure on the foot, helping the wound heal faster. Patients may be prescribed a removable cast walker or specialized offloading shoes to support the treatment process.
5.8. Controlling perfusion
Atherosclerosis causing complete obstruction.
Severe critical limb ischemia, which increases the risk of amputation.
5.9. Limb revascularization
Vascular reconstruction intervention or intravascular stent placement.
Arterial bypass surgery to improve blood circulation to the foot.
Today, with advances in medicine, many advanced methods have helped improve the effectiveness of treating and preventing diabetic foot complications.
At HIU Hospital, we provide modern medical solutions to help patients comprehensively manage diabetes complications. If you have concerns or suspect you may be experiencing a diabetic foot problem, please contact HIU Hospital right away for timely advice and support!...