Diabetes Mellitus or simply diabetes is very common in our today society. We have special clinics in our hospitals whereby we follow up patients with diabetes in order to optimize their diabetes control and the drugs for diabetes in our patients. In these visits, we also emphasize on diet, lifestyle and general care for people with diabetes. On the care, we educate our patients on the care of the feet in order to prevent diabetes ulcers/foot since it’s easy to get ulcers if not careful due to reduced protective sensation of pain and the healing is slower compared to general population since there is usually compromise of the blood supply from micro-vascular disease. When infected, it’s not easy to treat because of the compromised reach of the antibiotics due to the same.
If care is not taken, a wound can develop on the foot and infection can occur as a consequence. Diabetic foot infection can range from simple superficial cellulitis, deep skin and soft tissue infection, acute and chronic osteomyelitis. This means that the infection can spread to the bones if not treated making it more difficult to manage. See your doctor if you develop a wound and you are diabetic.
Wagner-Meggit classification of diabetes foot.
Grade 0 – foot symptoms like pain only.
Grade 1 – Superficial ulcers.
Grade 2 – Deep Ulcers.
Grade 3 – Ulcer with bone involvement.
Grade 4 – forefoot gangrene.
Grade 5 – Full foot gangrene.
Feet Care in patients with Diabetes.
Optimum sugar control is essential in all patients with diabetes in order to minimise complication such as diabetes foot an others. Comply to medications prescribed by your doctor.
Patients should stop smoking since this compromises blood supply to the feet further due to micro-vascular disease.
Inspect the feet daily especially between the toes, don’t walk bare foot and don’t wear shoes that apply pressure on the feet.
Avoid exposure to cold, friction and moisture between the toes. Keep the feet clean and dry.
Avoid use of external heat (heat pad, hot water bottle, hydrotherapy). If you are using warm water for baths in cold places, ensure someone else checks the warmth of the water for you since you can be deceived due to reduced peripheral sensation. Be very careful not to develop a wound cause of hot water.
Be careful in trimming toe nails. You can seek help in trimming the nails. Patients with diabetes should be very careful to avoid any kind of foot trauma.
When you develop any wound, see your doctor for assessment. Depending on the depth, wound care will be advised, dressing, choice and duration of antibiotics for infection control, debridement to remove dead tissues and imaging to see if the infection has reached the bone, all this will be decided by your doctor depending on the findings.
It is our prayer that we live healthy lives!
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