Diabetic foot ulcer can happen if we do not take care of our feet. Let us admit it. Sometimes we ignore and abuse our feet. How? By wearing uncomfortable shoes. We don't wear socks with our shoes and we either ignore our blisters and calluses or pick on them.
To avoid diabetic foot ulcer, we can no longer ignore this. The macrovascular and microvascular complications have an effect on the blood circulation to the feet. They affect the nerve cells in the feet which controls sensation which means we will not be aware of any injury to them.
The injury could then become infected, with the wound not healing properly. Thus this could spread to the bone and develop gangrene. This could lead to amputation. So we should do everything in our power to avoid diabetic foot ulcer. Perhaps we will avoid it better if we know the causes of this.
Reasons Behind the Development of Diabetic Foot Ulcer:
Wearing tight shoes that do not fit properly can be grounds for undue pressure that raises the risk of ulcer development
Lack of sensation in the feet makes one unable to be aware of the injury
Structural defects such as bunions and corns are predisposed to the formation of boils and sores
Formation of callous can give rise to the development of boils and sores because the usual sites for these are in the bottom of the feet where callous made it lose some padding
Loss of the oxygen and nutrient supply to the feet
Narrowing of the large blood vessels to the lower extremities
How can we prevent diabetic foot ulcer? We have to accept the responsibility to examine the feet closely every day. And if you smoke, stop for smoking is particularly harmful to blood circulation. In fact, most amputations happen to those who smoke.
Have a diet of low saturated fat that will lower the cholesterol level because this will help in the overall management of the condition. Otherwise, the narrowing of the blood vessels will block the supply of oxygen and nutrients to the feet. Once there's evidence of this, consult a vascular surgeon.
Treatment of the diabetic foot ulcer is a problem because it is not easy to get precise bacterial cultures that will help determine the right antibiotic therapy. The infection could therefore reach the bone which is frequently difficult to treat. I cannot stress the fact that prompt care is crucial.
How Do We Treat Foot Injury with First Aid Procedure?
Wash the area that shows injury with a mild antibacterial soap and warm water.
Put on a mild antiseptic like hydrogen peroxide. Avoid the use of iodine. Instead, apply an antibacterial ointment.
If needed, cover the injured area with band-aid or sterilized gauze. This should keep the wound free from dirt.
Allow the wound to heal properly by getting the feet rested. If the affected area becomes painful, red and swollen, do not waste time. Call the doctor right away.
A diabetic foot ulcer may be treated with bed rest. Foot supports can also help. If infected, antibiotics can be used but this should be closely monitored by you and your doctor. We do not want it to get out of control as the consequence is devastating.
Diabetic Foot Ulcer and Prevention
Diabetic foot ulcer can be prevented by paying close attention to foot care and managing foot injuries properly. Inspect the feet daily by yourself or a caretaker. Clean gently with soap and water and then apply topical moisturizer to keep skin healthy and able to resist injury and breakdown.
Get the doctor to inspect the shoes for proper fit and support. Many can use athletic shoes and thick absorbent socks but some may need custom shoes which are now covered by Medicare Part B when the doctor certifies the need. Minor foot problems can be made worse by home remedies so avoid heating pads, hot soaks, and harsh agents like iodine, astringents and hydrogen peroxide.
Here are some good selections of diabetic shoes. After you get into the store, just click the word Diabetic Apparel on top and scroll down. You will find some shoes there:
Dr. Luis Lomeli admitted a young woman patient to Modesto Scenic General Hospital's Intensive Care Unit for recurrent Diabetic Ketoacidosis. She had Type I Diabetes Mellitus as a teenager and she was not compliant. He talked to her as to why she had not followed her insulin treatment. He told her the possible risks of uncontrolled diabetes. After discharge, she didn't show up for the follow-up.
After three years, Dr. Lomeli was asked to testify because this patient was suing her primary care provider for not sending her to the eye doctor. The patient was now blind due to retinopathy. The doctor does not know the outcome of the case but he cautioned all providers to document what information they give to their patients. Here' a video that this doctor wants to share with you.
In the 1970's a medical student at Harvard named David Knighton, m.d., researched the factors in the blood that promote healing. From the blood platelets, he cut off the proteins that promoted growth. These encouraged blood vessel and scar tissue formation, attracting new skin cells.
This led the way to a new therapy system for those whose wounds will not heal. A new drug was developed called Procuren, which is derived from the patient's own blood platelets that aids in clot formation. When this is applied directly to the wound, the healing is quicker. Some are even calling this a miracle.
In severe cases when the wound entails a large blood vessel, a circulatory vascular bypass may be called for. The purpose of this is to provide blood flow to the part that is completely cut off from the blood supply and so is cut off from the oxygen supply.
Another therapy that I found out in my research is hyperbaric oxygen therapy where the patient is made to breathe 100% oxygen while in hyperbaric state (where barometric pressure is higher than the one at sea level) The doctor closely supervises this which can last for two hours, everyday, for five days a week until the wound seems to respond.
We have to take responsibility for our feet to avoid the formation of diabetic foot ulcer. What does it look like anyway? It looks like a crater, a depression on the skin of the diabetics. We already know what it can lead to, so we should make sure we take good care of our feet. Here's a checklist to read everyday to remind us what to do:
Diabetes management is crucial. Eat healthy food, exercise and take medication as ordered. This way we can keep our blood sugar level as normal as possible. Research has shown that this will lower the risk of nerve damage by a whopping 66%.
Keep feet clean and dry, making sure the area between the toes are also dry.
Guard against injury to the feet.
Wear cotton or wool socks which are best for this condition and change them everyday.
Wear shoes that fit correctly. Don't wear open-toe shoes for obvious reason.
If new shoes are uncomfortable, take them to a shoe repair shop so they can be broken in mechanically.
Avoid extremes of hot and cold so do not use hot water bottles or heating pads .
Avoid using over-the-counter medication for treating callous, corn and such that use strong chemicals.
Never walk barefoot even at home.
Help promote good circulation.
Avoid tight-fitting garters, girdles, socks and shoes.
Exercise your feet and legs everyday by walking.
Avoid crossing legs at the knees.
Do not smoke as this constricts the blood vessels.
So you see, we can avoid amputation by taking care of ourselves. Nobody else can do this for us. We should be our own advocates to stay healthy. My fervent wish is that the dire consequence will not happen to the readers of this site. It can be done!
There's news from Bahrain about the diabetes education center they're going to open there that will house a swimming pool, a gym, and the offices of the Bahrain Diabetes Society. On the heel of this announcement, they had Habiba Al Tawqi talk about her experience of losing her feet and her kidney because she rebelled against her parents and doctors and didn't follow their advice.
Now she has learned to fight. She said she does not want to lose anything else to diabetes. She added that she lost her feet and kidney because she did not take her medication regularly. Neither did she eat a healthy diet. Her goal now is to reach as many teenagers as she can because they are vulnerable to this situation. She advises them to follow their doctors' orders so they won't lose their kidney and feet just like she did. She was sponsored by Princess Haya bint Al Hussain who is the wife of the Dubai ruler.
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