The diabetic foot it is a chronic complication of diabetes, and in turn of metabolic uncontrolled by sustained hyperglycemia (high blood sugar or glucose). That definition is provided by the doctor Pedro Luis Mena, director of the Diabetic Foot Unit of the Medical Center for Diabetes, Obesity and Specialties (Cemdoe), who also highlights that amputations are the last treatment option to consider.
However, he admits that in some situations it is unavoidable because you have to choose between amputation and life.
“And the objective is always to safeguard the life of the patient, it is our duty to make a good assessment of the commitment of the general state of the patient, existence of gangrene me sepsis. All diabetic foot professionals must ensure that we offer treatment and monitoring focused on limb salvage, always prioritizing the integrity of our patients “, indicates Mena.
The specialist discusses the subject with regard to the results of various scientific studies that have estimated that, of the chronic complications of diabetes, ulceration and amputation of the foot are the most preventable, estimating that 50% of these could be avoided by means of health education oriented to the self-care of patients and timely prevention.
Every year in the Dominican Republic there are 30,000 cases of people with lower extremity ulcers from diabetes and they take place around 5,000 foot amputations. The doctor assures that the main cause of hospitalization of patients living with this condition are infections. Avoiding them is a joint effort and requires the commitment of the patient, caregiver and their doctor (comprehensive care), to prevent these amputations that would put their quality of life at risk.
Prevention is important
This condition can be avoided with “an optimal control of glucose levels, go to preventive foot consultation from the moment of diagnosis of the condition, and at least once a year, to determine the risk factors for ulceration through neurological, vascular and bone deformities evaluation ”, says Mena, who has a master’s degree in the diagnosis and treatment of diabetic foot, graduated from the Autonomous University of Barcelona.
Stresses the importance of education and daily self-care of the feet. In addition, it points out that for the comprehensive approach to the patient it is necessary to identify biomechanical alterations in a timely manner and the analysis of the footprint to avoid ulcerations related to gait disorders, mainly by performing specific discharges and / or insoles that reduce pressure points on the foot. avoiding hyperkeratosis and / or calluses that in the future can cause an ulcer.
Main risk factors
Among the main risk factors for developing a diabetic foot are:
• Metabolic decontrol
• Diabetic neuropathy (damage to the nerves in the feet)
• Diabetic arteriopathy (damage to the arteries in the feet)
• Biomechanical and orthopedic alterations (bone defects in lower limbs)
• Inappropriate footwear
• Foreign body in footwear (objects inside)
• Falls or accidents
• Presence of other chronic complications (retinopathy, diabetic nephropathy)
• Previous ulcer and / or previous amputation
• Poor foot hygiene