Infected diabetic foot: symptoms and care

More than 16 million adult Brazilians suffer from diabetes and the disease kills 72,000 people a year in the country, according to a report from the World Health Organization reported in 2016. In Brazil, the prevalence of diabetes is 8.1%, slightly below the world average, and is higher in women (8.8%) than in men (7.4%).

overweight affects 54.2% of Brazilians, obesity, 20.1% and physical inactivity, 27.2%. Diabetes causes the deaths of 72,200 Brazilians over 30 years old and represents 6% of all deaths. Excess glucose in the blood accounts for 106,600 more deaths per year in Brazil.

What is diabetic foot

Diabetic foot is defined as the presence of infection, ulceration and / or destruction of deep tissue associated with abnormalities neurological and various degrees of peripheral vascular disease in people with diabetes (International Working Group on Diabetic Foot, 2001).

On the website of the Brazilian Society of Angiology and Vascular Surgery we find the following explanation: the high level of sugar in the blood can affect nerves and blood circulation in the legs. Nerve damage can cause tingling, pricking, burning and even numbness of the feet. In this way, the diabetic does not feel the lesions and they get worse and can become infected, which can lead to amputation of the feet and legs.

Diabetic foot care

Like everything else in medicine, prevention is the best behavior. All diabetics should become accustomed to the following procedures:

• Check your feet every day for cuts, cracks, bumps, blisters, wounds, infections, or unusual findings.
• Use a mirror to see the sole of your feet, if you you can not lift them
• Check the color of your legs and feet. If there is swelling, heat, or redness, or if you have pain, call your health care professional.
• Clean cuts or scratches with mild soap and water and cover with a dry dressing for sensitive skin
• Cut your nails straight
• Wash and dry your feet every day, especially between the toes.
• Apply a moisturizing lotion to the skin every day on the heels and soles of the feet. Clean any excess lotion
• Change your socks every day
• Always wear comfortable shoes that fit your feet
• Wear low-heeled shoes (less than 5 cm high)
• Buy shoes on
• Avoid extreme cold and heat (including sun exposure)
• Exercise regularly
• Seek out your health care team if you need to advice or treatment.

Symptoms of diabetic foot

Whenever a diabetic patient, most often poorly controlled, perceives an abnormality in their foot, whether sensation, temperature, color, deformity of the bones of the foot or tissues of this region, presence of inflammation or infection, we are faced with the possibility of a diabetic foot.

The most frequent symptoms are tingling and burning sensation (which typically improve with exercise). Can decreased sensitivity appear as painless traumatic lesions? sometimes the diabetic gets hurt and does not notice and this injury can increase and infect? or from reports, such as losing the shoe without notice.

Ischemic foot symptoms

The ischemic foot is typically characterized by a history of walking pain that forces the diabetic to stop, rest for a moment and then return to walking, what we call intermittent claudication, and / or pain when raising the limb.

At physical examination, it may be noted that the foot may become somewhat red when placed down and pale when elevated. When you feel it, the foot is cold, and it may be difficult for the blood to reach the extremities due to a circulation problem.It can be dangerous for your feet:

Do not cut your own calluses or calluses

• Do not treat your nails in wedge or chipped alone with razors or scissors. Look for your health care team
• Do not treat yourself with medications to treat calluses and warts. They are dangerous for people with diabetes
• Do not apply heat to your feet with hot water bottles or electric blankets. You can burn your feet without realizing
• Do not leave your feet wet
• Do not take a hot bath
• Do not leave a moisturizing lotion between your toes
• Do not walk barefoot in or out of the house
• No wear socks, tight tights, suspenders or elastics on the legs and feet
• Do not choose insoles on their own, they can cause blisters if they are not the exact shape of the feet
• Do not sit for long periods
• Do not smoke.
• If the patient is injured and has a wound, the possibility of infection is high due to lack of circulation. It is necessary to recognize the lesion and its treatment as soon as possible so that this infection does not increase a lot, spread and the patient loses his foot due to a very big impairment. Sometimes to save a life, we need to take more aggressive measures, such as an amputation of part of the foot, to prevent this infection from being progressive and life-threatening.

Approximately 40 to 60% of all nontraumatic lower limb amputations are performed in patients with diabetes; 85% of diabetes lower limb amputations are preceded by a foot ulcer. Four out of five ulcers in diabetic individuals are precipitated by external trauma. The prevalence of an ulcer in the feet is 4 to 10% of the diabetic population. These are expressive data and should serve as an alert for the entire population.

Sources consulted:

SBACV website

• International Diabetes Consensus
• Diabetes Foot Manual - Ministry of Health

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