Dr. Mehdi Abd Al-Sahib – Orthopedic Surgeon
Diabetes is a high blood sugar level above the normal range (80-110 mg/100 mm). The reason is the lack of insulin production in the body or its inability to do its job or both. This disorder is common worldwide.
There are two types of diabetes: Diabetes in young people, it’s mostly genetic and environmental reasons trigger it. Diabetes in old people, it often occurs due to a defect in insulin receptors on the surface of cells.
Some of the main symptoms include frequent urination, severe thirst, weigh loss, vision problems, fatigue, and a weakened immune system. Symptoms may appear in the form of severe complications, such as a sharp drop and rise in blood sugar. One of the chronic complications is vascular injury, nerve and muscle injury, eye and kidney problems. Diabetic foot is a common complication, as more than 25% of diabetics suffer from complications due to lack of blood circulation and neuropathy, in addition to lack of immunity.
Diabetic foot is a medical condition in which the foot is damaged in structure, function, or both as a result of complications of diabetes. And diabetic foot causes a lot of health problems for patients and may threaten them due to amputation that may affect their feet. In America, 75,000 amputations are performed annually due to diabetes. The most common clinical indicators are:
First: The symptoms: Impaired sensation or abnormal foot sensation due to peripheral sensory neuropathy, difficulty maintaining balance while standing or walking due to peripheral motor neuropathy, recurring pain in the feet without wounds or injuries, feelings of fatigue and muscle strain due to blockages in the arteries and the lack of response of wounds or ulcers to the usual treatment.
Second: Clinical signs: Keratoses, cracks, ulcers, blisters, darkening and cracking of nails, red or blue spots on the heels and the tips of the fingers and white spots between the toes, swellings and wounds that do not heal and the discharge of pus, which is a late sign, deformities and change in the shape of the toes due to peripheral motor neuropathy, and finally, gangrene (blackening of the toes or soles of the feet), which is a very late sign.
Causes of diabetic foot: Most common causes are:
1- Uncontrolled blood sugar level is one of the most important reasons.
2- Factors leading to atherosclerosis: smoking, high blood pressure, obesity, lack of movement, and stress.
3- Bacterial infection due to cracks and ulcers, accompanied by weak immunity in diabetic patients. When these two factors combine, they result in the infiltration of microbes into the deep tissues of the foot, causing deep infections that spread rapidly and threaten the entire foot.
4- Other diseases such as heart disease and stroke may cause diabetic foot:
(A) Heart diseases, especially coronary artery failure and heart failure, double the impact of peripheral arterial insufficiency on the foot.
(B) Stroke, hemiplegia, and heart failure patients who are forced to stay in bed for a long time, the pressure on the heel and the back of the foot may cause a bed ulcer in the foot and thus develop into diabetic foot.
5- Foot deformities for reasons other than diabetes are usually more dangerous because of the lack of pain sensation, weak immunity, poor blood circulation, and slow wound healing.
6- Some professions make feet more prone to disease, such as (A) Work that requires wearing heavy shoes. (B) Work that requires long periods of standing or walking. (C) Working in farms, fields, or rugged areas. (D) Working with chemicals. (E) Standing on the hot ground. (F) Humidity. (G) Thorns and nails.
7- Some environmental and social factors contribute to the development of the disease. For example (A) Hot climate encourages the wearing of slippers that do not protect against injuries, heat, or drought (B) the habit of walking barefoot. (C) Clipping the nails in the wrong way due to poor eyesight. (D) Lack of awareness of foot care. (E) The lack of educational medical programs in the media. (F) Traditional medicine such as cautery, cupping, herbs, etc. may aggravate the condition of the diabetic foot. (G) Rodent and insect bites.
We wish you good health.
