Dr. Mehdi Abd Al-Sahib – Orthopedic Surgeon
Why diabetic foot more prone to serious complications:
The function of the foot exposes it to injuries even in healthy people due to its direct contact with the hardness and zigzags of the ground. Feet also bear the pressures of body weight, and shoes are typically less flexible compared to other items of clothing. The feet are the least part of the body that receives care and hygiene, compared to, for example, the hands. There are other reasons why diabetic people are more prone to feet-related health problems, the most important of which include:
1- Diabetic patients are more exposed to external injuries due to loss of feeling and cracks in the feet, in addition to changes and distortions in the shape of the feet and toes.
2- Diabetic patients are more exposed to complications due to the delay in detecting injuries resulting from the patient’s loss of feeling of frequent injuries such as friction with hard parts in new shoes or friction with the ground at certain points during prayer or sitting in special positions. The narrowing and blockage of the arteries that deliver blood to the feet weaken their ability to deal with infections and microbial infections. This in addition to weak immunity and complications of diabetes in other organs such as the heart and kidneys.
Risks of diabetic foot:
Diabetic foot is a disease that begins gradually, slowly and silently, but complications and deterioration occur so quickly that they lead to damage to parts of the foot in a few days. Failure to treat many cases may lead to significant losses, the least of which is the loss of efficient function of the foot such as deformities or the inability to walk long distances, and the most dangerous of which is the death of the patient. And between these two degrees, there are other risks as a result of minor surgeries or the loss of toes, parts of the foot, the whole foot, or even most of the lower limb (depending on the level of amputation).
Why treatment fails for some patients:
Reasons related to the patient or the doctor, and others related to the disease itself and social and economic conditions.
1- The patient: Not realizing the seriousness of the disease and negligence in treatment.
2- The doctor: Not having the appropriate scientific background and effective standard treatment plans.
3- The disease itself: The lack of symptoms of the disease in its early stages leads to a delay in its detection.
4- The role of the Ministry of Health in providing appropriate treatment and special centers for diabetics whose treatment takes months, and encouraging scientific research and training doctors on early diagnosis and the latest treatment methods in advanced medical centers.
5- Socio-economic conditions, as most patients are from average-income and poor families who cannot bear treatment expenses for long periods of time, and thus treatment stops, rapid deterioration happens, and they resort to critical solutions, including amputation.
Risk levels:
First level: Some symptoms are without organic signs such as loss of feeling or numbness in the feet.
Second level: Signs of a superficial injury, such as superficial ulcers that heal with appropriate medical treatment.
Third level: When there are signs of foot loss and chances of recovery are poor, such as deep infection and severe arterial insufficiency.
Fourth level: Signs of crush injury and no chance of rescue, such as total infection and complete functional collapse.
Diagnosis:
The patient or those who suspect themselves of symptoms and signs such as the ones we mentioned should see a doctor in order to perform the necessary tests, including an examination of the blood flow rate and arterial stenosis by means of an ultrasound device (Doppler examination) which gives detailed and accurate information to the surgeon about the extent of the damage, and its percentage, that may reach (70% – 90%) and on the basis of which the doctor decides whether the patient needs to undergo surgery or not. But before everything, The patient should control his blood sugar level, quit smoking, and take medications for high blood pressure if he suffers from hypertension. The doctor must not resort to surgery except as a final option.
We wish you good health.
