Contents

  • Symptoms of Diabetic Foot Development

  • Types of Diabetic Foot

  • Stages of Diabetic Foot Development

  • Diabetic Foot: Which Doctor to Consult?

  • How Is Diabetic Foot Treated?

  • The Danger of Diabetic Foot

  • Prevention of Diabetic Foot

Diabetic foot is one of the most severe complications of diabetes mellitus. It manifests as ulcers that do not heal and gradually increase in size. First, soft tissues are destroyed, then muscles, blood vessels, and nerves. If the disease is not treated in time, necrosis may spread to the ligaments and bones of the foot, which threatens the development of gangrene and limb amputation.

To prevent this, it is recommended to regularly monitor blood sugar levels, as well as examine the skin of the feet and seek medical help immediately when the first symptoms appear.

Symptoms of Diabetic Foot Development

With the development of this complication, the anatomical and functional properties of the foot are impaired. This usually occurs 5–7 years after diagnosis if blood sugar levels remain elevated most of the time.

At first, symptoms may be mild, which is why some patients overlook them. Typically, it begins with reduced sensitivity, dry skin, and mild pain at rest and at night. At the same time, discomfort often disappears after walking. Soon after, small cracks and ulcers appear on the skin.

The development of diabetic foot is accompanied by symptoms such as:

  • Dryness and peeling of the skin;

  • Calluses and cracks;

  • Small rash;

  • Non-healing ulcers;

  • Swelling;

  • Deformation of the foot;

  • Burning sensation in the legs;

  • Heaviness, fatigue while walking;

  • Limping;

  • Numbness;

  • Decreased sensitivity;

  • Redness, bluish or pale skin;

  • Yellowing of nails.

Types of Diabetic Foot

Depending on the main cause that triggered tissue destruction, 3 types of diabetic foot are distinguished:

  • Ischemic – develops with damage to the blood vessels of the foot, causing circulatory disorders and hypoxia of soft tissues. As a result, swelling and blisters appear, which crack and turn into ulcers with uneven edges. Sensitivity is preserved, and the patient feels pain while walking. Calluses and foot deformities are absent.

  • Neuropathic – develops with damage to the nerve endings, leading to reduced sensitivity to touch and temperature changes. The skin on the feet and shins becomes drier and begins to peel. Rough calluses, deep cracks between the toes, and ulcers with smooth edges form on the foot. Over time, foot deformity also occurs. A distinctive feature is the absence of pain due to reduced sensitivity.

  • Neuroischemic (mixed) – develops with damage to both blood vessels and nerves of the foot, accompanied by corresponding symptoms.

Stages of Diabetic Foot Development

The symptoms of diabetic foot gradually increase with damage to more tissues. Depending on this, 5 stages of the disease are distinguished:

  1. Stage – shallow ulcers form on the foot that do not affect deeper tissues.

  2. Stage – ulcers spread to subcutaneous tissue, then to muscles and ligaments.

  3. Stage – joints and bones are affected, and abscesses and osteomyelitis develop.

  4. Stage – tissue necrosis occurs, and gangrene develops on the supporting part of the foot. The leg gradually turns black starting from the toes (in this case, amputation can be avoided if surgical treatment is carried out in time).

  5. Stage – the size of gangrene increases, up to affecting the shin (this process is irreversible, and patients undergo limb amputation).

Diabetic Foot: Which Doctor to Consult?

With the appearance of diabetic foot symptoms, you should consult an endocrinologist who controls the treatment of diabetes mellitus. He will conduct an examination, prescribe blood tests and other studies to assess the extent of damage. After this, the specialist will select treatment and, if necessary, refer you to a surgeon for consultation.

How Is Diabetic Foot Treated?

The treatment strategy for diabetic foot depends on when the patient sought medical help. At an early stage, conservative therapy methods may be sufficient, while at later stages, surgical treatment is required, up to leg amputation in cases of complications.

Conservative treatment includes:

  • Treatment of ulcers with antiseptic agents;

  • Taking antibiotics to fight infection;

  • Taking medications to normalize blood pressure and improve foot blood supply;

  • Taking painkillers and other medications to improve well-being;

  • Adjustment of diabetes treatment.

Such treatment may be long-term and requires regular doctor visits, adjustment of prescriptions, and strict adherence to all recommendations. In some cases, it allows stopping the progression of the disease and avoiding surgery.

If the pathological process affects the deep tissues of the foot, including blood vessels, joints, and bones, the patient is prescribed surgical treatment. Depending on the size and extent of the lesion, the following are performed:

  • Angioplasty – during surgery, the surgeon removes gangrenous areas and performs vascular plastic surgery to restore normal blood circulation.

  • Necrectomy – removal of gangrenous tissues along with some healthy ones to prevent re-infection (applied if the pathological area does not exceed 2 cm).

  • Endarterectomy – removal of blood clots and atherosclerotic deposits from large arteries to restore normal blood flow.

  • Autovenous bypass – creation of an additional venous branch to restore and improve blood supply to the foot.

  • Arterial stenting – widening of arteries with the installation of a stent.

The surgeon decides which method will be most effective depending on the patient’s condition.

After surgical treatment, drug therapy is usually prescribed to improve wound healing, control diabetes mellitus, and prevent complications.

The Danger of Diabetic Foot

Diabetic foot is one of the most severe complications of diabetes mellitus. Often, at early stages, leg sensitivity decreases, so the first symptoms go unnoticed. Many patients consult a doctor only at the late stages of the disease when surgical intervention is required.

After ulcers appear, there is a risk of infection, development of abscesses, and tissue necrosis. Without timely therapy, this can lead to gangrene of the leg – an irreversible process treated only by amputation.

Prevention of Diabetic Foot

To reduce the risk of developing diabetic foot and worsening of the disease, it is recommended to:

  • Be monitored by an endocrinologist for diabetes control;

  • Follow the prescribed diet and take antidiabetic drugs on time;

  • Quit smoking and other harmful habits;

  • Wear quality shoes with a comfortable last and orthopedic insole so that they do not squeeze the foot;

  • Wear socks and tights made of natural fabrics without tight elastic bands;

  • Monitor foot hygiene daily and examine feet for changes;

  • Perform careful pedicures without damaging the skin;

  • Apply moisturizing cream to the skin;

  • If dryness, cracks, ulcers, or other damage appear, immediately consult a doctor.

Also, with the appearance of diabetic foot symptoms, patients are advised not to walk barefoot, not to stay long in the cold, not to steam their feet, not to use heating pads for warming, and not to cover ulcers and cracks with adhesive plaster.

Sources:

U.S. Department of Health & Human Services
Medical News Today
BMJ Publishing