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Weak point: lesion of the legs in diabetes mellitus
The doctor answered how the patient can avoid this problem.
Leg involvement is the most common complication of diabetes mellitus. There are two reasons for this – nerve injury (neuropathy) and damage to large vessels (angiopathy).
Endocrinologist at the Khimki Regional Hospital
Why is this happening and what are the consequences?
Our expert Larisa Valentinovna Shcherbakova answered these questions.
Long-term decompensation of diabetes mellitus, duration of the disease for more than 10 years often leads to nerve damage. This is evidenced by pain in the legs, the appearance of goose bumps, tingling, numbness, burning sensation of the skin. Symptoms can be excruciating, annoying, but more dangerous. For neuropathy, a decrease in the sensitivity of the legs is characteristic, the ability to perceive the effects of high and low temperatures disappears, pain becomes imperceptible (for example, an injection with a sharp object), vibration.
The patient misses minor injuries, for example, wounds when foreign objects get into the shoes, cuts when processing nails and calluses.
The decrease in sensitivity, combined with the deformity of the feet, which is common in diabetes and overweight, leads to an inappropriate distribution of body pressure when walking. The result is foot injuries up to the formation of ulcers in places of greatest stress. The problem areas can become inflamed, which leads to an infectious process. In severe advanced cases, it progresses, purulent inflammation of the phlegmon develops. Lack of treatment leads to tissue necrosis – gangrene.
There is an ischemic complication. It is caused by damage to the arteries as a result of the manifestation of atherosclerosis. Elevated blood glucose levels exacerbate the severity of the atherosclerotic process.
Deterioration of the condition of the arteries leads to impaired circulation in the legs. If the situation is complicated by neuropathy (it happens that two forms of the problem appear at the same time), the likelihood of gangrene increases, which means that amputation of the limbs is especially high.
What to do?
It is important for all patients with diabetes mellitus to monitor blood glucose levels, give up bad habits, and regularly measure blood pressure and cholesterol. Weight control is important, extra pounds increase the risk of complications. Therefore, one of the elements of prevention is an active lifestyle.
It is necessary to undergo an examination in the diabetic foot office once a year and follow the rules of foot care. This reduces the risk 90% of the time.
Care instructions
Examine your feet daily, including the skin between your toes. If blue spots or white (bloodless) areas appear, see a surgeon urgently.
Wash your feet daily with warm, but not hot, water. Eliminate thermal procedures, do not steam your feet. Wipe them dry while blotting your skin.
Don’t even go barefoot around the house.
Give up tight shoes, choose comfortable models. Remember the rule: if your feet are swollen, it is better to try on shoes in the store in the evening. At this time, the real picture is clearer. Don’t buy shoes made from artificial materials.
When treating wounds, do not use aggressive agents – alcohol, iodine, brilliant green.