If a patient has had diabetes for more than fifteen to twenty years, in 80 percent of cases the arteries can be damaged. In such cases, surgery may be necessary.
Diabetes mellitus is a pathological condition characterized by damage to blood vessels, skin, soft tissues, bones, and peripheral nerves in the joints. Often, bone and joint damage and purulent necrotic processes develop. Also, the capillaries in the legs are damaged (microangiopathy) and the tissues become malnourished and deprived of oxygen. Metabolic processes are disrupted, excess products are not excreted, resulting in severe changes in hypoxic tissues and the development of gangrenous-necrotic processes.
Diabetes mellitus develops atherosclerotic lesions (macroangiopathy) and is very severe. Atherosclerotic lesions occur in the arteries of the thigh, knee, and foot.
Polyneuropathy, or damage to nerve fibers (somatic and autonomic neuropathy), can lead to the development of trophic ulcers in the legs of patients with diabetes. In most cases, the shape of the sole of the foot changes, and the patient's posture is incorrect, both when walking and standing. The soles of the feet, which are less sensitive to hot or cold temperatures, are more likely to be damaged by mechanical, thermal, or chemical influences, and the risk of purulent necrotic lesions increases.
Diabetic osteoarthropathy is characterized by excessive excretion of calcium and other salts.
In diabetes, neuropathic, ischemic, and neuroischemic types of soles of the feet are distinguished. At the onset of pain, patients become more tired, cold, and numb.
When diabetes lasts a long time, the soles of the feet change shape, flat feet appear, the toes become hammer-like, and there are lumps under the paws. The patient is lame, and when there are scars and trophic ulcers on the legs, they are difficult to heal.
Examination of the soles of the feet on a podoscope is important in diagnosing the disease. Certain processes in the treatment of patients with foot pain (for example, the exact type of medication, healing the skin around the wound and prevention of perifocal inflammation, stopping the purulent-necrotic process and inflammatory changes in the wound, strengthening the immune system, giving more relief to the feet, carbohydrates during treatment such as improving the exchange rate).
In case of complications of infection, ischemic lesions and hyperglycemia, patients must be treated with insulin and prescribed drugs and ointments that relieve leg pain and reduce the symptoms of polyneuropathy. It is important to clean the wound well, to heal the surrounding skin, and to renew the bandage every day.
Prevention is better than cure. To do this, it is important that patients with diabetes monitor their toes every day, take proper care of them, and seek medical attention immediately if necessary.
Zilola DOSOVA,
The Republic is specialized
endocrinology scientific-practical
medical center
“Diabetes pus
Complications ”doctor,
endocrinologist.
