THE DIABETIC FOOT

That gathers the whole of the pathological demonstrations reaching the foot, directly in connection with the subjacent disease diabetic, concerning mainly the peripheral nerves and/or the arterial circulation of the lower extremities, these demonstrations being often precipitated by occurred of an infection.
5 to 10 % of the diabetics in Algeria suffer from lesions of the foot of which 7 % undergo an amputation.

Causes

The chronic hyperglycemia, badly balanced, not controlled with the passing of years involves complications vascular and neurological, which generates on the wounds a delay of cicatrization and infections.
The lesions of the foot are very often caused by minor traumatisms. The factors starting most frequently in question are the unsuited shoes, an insufficient hygiene, badly made care of chiropody, not perceived sources of heat…

Symptoms

The attack of the nerves involves:

  • Progressive reduction in the perception of the pain
  • Progressive reduction in the perception of heat
  • Reduction in sudation: The reduction in perspiration can appear banal but it weakens the skin while making it dry and friable. The risk of wound is increased.

The attack of the vessels (arteries) involves:

  • Pains in the legs, the calves or the feet, with walk or the effort.
  • Cold feet, pale, blue when they hang a long time in sitting position, white when they are raised.
  • Fine and brilliant skin.
  • Foot thin, atrophic, thickened nails, depilation.
  • Badly perceived pulses not or.

These modifications appear by the progressive loss of the various feelings which protect from the wounds. Its losses are not very perceptible and the person reached often does not realize there.

Prevention

Simple and effective, the prevention of the diabetes is with the range of all. This prevention must be adapted to each patient by taking account of the rank of organic risk. It is based on 3 points:

  • • The education of the patient and his entourage is fundamental in the prevention: it makes it possible to improve knowledge and the behaviors of the patient as for the car examination of the feet, with the hygiene and the care of the feet.
  • • The attack of a balance glycemic satisfying is a privileged objective.
  • • The local care podologic of primary and secondary prevention.

References:

1- M. Leutenegger, D. Malgrange, P. Fontaine. Le pied diabétique. 1996.
2- JP.Brion. Management of diabetic foot. Infectious Diseases, CHU de Grenoble. January 2012
3- Higher Authority of Health. Prevention sessions of foot lesions in the diabetic patient, the podiatrist. July 2007