Amputations can be avoided - In case of diabetes consider the feet

Prevention of diabetic foot syndrome
Many people with diabetes develop as a secondary disease a diabetic foot syndrome, which often requires the amputation of affected limbs. If there are changes in the foot, diabetics should consult a doctor in a timely manner, experts from the Freiburg University Medical Center warn in a recent press release. Special measures may help to significantly reduce the risk of diabetic foot syndrome.

According to the doctors, the diabetic foot syndrome can damage both the nerves and the blood vessels of the foot. The consequences are comparable in both cases. Badly healing wounds occur, tissue dies and at worst requires amputation. Various countermeasures can, however, significantly reduce the risk and interdisciplinary treatment of those affected can often avoid amputations, according to the University of Freiburg.

Circulatory disorders and polyneuropathy
If the nerves are damaged or destroyed due to years of high blood sugar levels, those affected develop so-called polyneuropathy. Numbness, tingling, pain or even paralysis may occur. Due to the reduced sensation of pain, injuries to the feet often go unnoticed for a long time, the experts report. This can cause badly healing wounds that ignite and spread into the depths. In case of damage to the blood vessels, the patients show circulatory disorders, which can lead to the so-called "intermittent intermittent claudication" and in extreme cases to the death of the toes or even the entire leg, said the Freiburg physicians.

Interdisciplinary care of patients
According to the experts in Freiburg, the treatment of diabetic foot syndrome is interdisciplinary. "There are several disciplines involved in optimal treatment success: diabetology, surgery, angiology, cardiology, infectiology, neurology, radiology, vascular surgery, and pain medicine," according to the University Hospital. According to Professor dr. Jochen Seufert, Head of the Department of Endocrinology and Diabetology at the University Hospital of Freiburg, "first the patient's blood sugar levels must be optimally adjusted to avoid complications in a diabetic foot syndrome." A study of the peripheral vessels of the feet and legs by Per ultrasound and angiography. In addition, the nerves on the feet and legs are examined to determine whether the diabetes is a nerve damage, the expert explains.

Take small wounds seriously
If there is a circulatory disorder, constrictions can be re-expanded with a catheter and stent implantations can be used, the physician continues. Comprehensive diagnostics and infectiological treatment for infections of the feet is very important. According to the University Hospital, "small wounds need to be taken seriously" in order to avoid amputations. For example, the diabetic foot syndrome is not without reason the largest focus of attention at the Department of General and Visceral Surgery of the University Hospital Freiburg. In wound consultation, after the treatment planning, the local wound care with special wound dressings, which should support healing.

Chiropody and special shoes for prevention
"For follow-up, patients are called in every two to three weeks to assess the healing and, if necessary, to adjust the therapy," reports Christian Moosmann, Nursing Specialist at the Department of General and Visceral Surgery at Freiburg University Hospital. For this purpose, state-of-the-art documentation techniques such as digital photo documentation, infrared camera thermography and digital area measurement would be used. In order to avoid a recurrence after healing of the wounds, patients are then prescribed a special footwear. This consists of an individually adapted soft bedding insert, guide elements in the shoe such as specially incorporated rollover soles and a seamless inner shoe. "A diabetic shoe does not have to be ugly today: The shoes do not differ at first glance compared to normal footwear," emphasizes Moosmann. The professional foot care, in which the costs are largely taken over by the health insurance, form an integral part of the prophylaxis of diabetic foot syndrome. (Fp)