To study Surgical Management of diabetic foot. INTRODUCTION Diabetes mellitus (DM) is one of the main problems in health systems and a global public health threat that has increased dramatically over the past 2 decades (1, 2). According to epidemiological studies, the number of patients with DM increased from about 30 million cases in 1985, 177 million in 2000, 285 million in 2010, and estimated if the situation continues, more than 360 million people by 2030 will have DM (3, 4). Patients with DM are prone to multiple complications such as diabetic foot ulcer (DFU). DFU is a common complication of DM that has shown an increasing trend over previous decades (5, 6, 7). In total, it is estimated that 15% of patients with diabetes will suffer from …show more content…
It is estimated that approximately 20% of hospital admissions among patients with DM are the result of DFU. Indeed, DFU can lead to infection, gangrene, amputation, and even death if necessary care is not provided (14). On the other hand, once DFU has developed, there is an increased risk of ulcer progression that may ultimately lead to amputation. Overall, the rate of lower limb amputation in patients with DM is 15 times higher than patients without diabetes. It is estimated that approximately 50%-70% of all lower limb amputations are due to DFU (8). In addition, it is reported that every 30 s one leg is amputated due to DFU in worldwide (9). Furthermore, DFU is responsible for substantial emotional and physical distress as well as productivity and financial losses that lower the quality of life (15). Diabetes has foot problems secondary to neuropathy and micro vascular changes. They are at increased risk of infection , ulceration, and trauma sometimes trivial can lead to collapse of foot also known as Charcot neuroarthropathy (16). The decisive factor for the etiology of the diabetic foot syndrome is diabetic neuropathy, macroangiopathy and the combination of neuropathy with macroangiopathy. If ischemia prevails, macroangiopathy decisively deteriorates the prognosis and leads together with local infection to amputation in almost all cases of Diabetic Foot Syndrome
Diabetes is a disease where the body is unable to produce or use insulin effectively. Insulin is needed for proper storage and use of carbohydrates. Without it, blood sugar levels can become too high or too low, resulting in a diabetic emergency. It affects about 7.8% of the population. The incidence of diabetes is known to increase with age. It’s the leading cause of end-stage renal disease in the US, and is the primary cause of blindness and foot and leg amputation. It is known to cause neuropathy in up to 70% of diabetic patients. Individuals with diabetes are twice as likely to develop cardiovascular disease. There are two types of diabetes: Type 1 and Type 2.
They include: heart and blood vessels, eyes, kidneys, nerves, gums and teeth. In regards to the heart and blood vessels, there are approximately 65% of death that is caused by diabetes due to major complication of heart disease and stroke. In the peripheral artery diseases diabetes also plays a major role in the cause of poor blood flow in the legs and feet. Many studies show that controlling diabetes can prevent or stop the progression of heart and blood vessel disease. Blood vessel damage or nerve damage may also lead to foot problems that can lead to amputations. More than 60% of leg and foot amputations not related to an injury are due to diabetes. Another complication of diabetes is the leading cause of blindness in the U.S. There has been a number of eye problems that if not addressed can lead to eye blindness which include: glaucoma,cataracts and diabetic retinopathy. Ninety percent of diabetic-related blindness as study shown could be prevented if there would be regular eye exams and timely treatment of diabetes-related eye problems. Furthermore, kidney failure is also one leading cause of further complication that resulted from uncontrolled diabetes in the U.S. It is said that drugs that help lower blood pressure can help the chance to developing kidney failure by 33%. Also diabetes on nerves can lead to loss of sensation or pain and burning of the feet because nerves are harmed due to over time high blood sugar levels. It can also
Those who are diabetic may also be in risk of blindness (diabetic retinopathy) and nerve damage (diabetic neuropathy). Diabetic neuropathy can lead to numbness in hands and feet, foot ulcers, and eventual limb amputation (World Health Organization). Taking preventive steps can help to avoid many of the complications of diabetes.
Most patients who have diabetes for an extended amount of time may end up with diabetic neuropathy, which is damage caused to the nerves; it affects the peripheral nerves, autonomic nerves, and focal nerves. From the high blood sugar, it can destroy parts of the patient’s blood vessels, heart, and kidneys. If diabetes is not treated, it will almost always cause heart disease or kidney disease.
Diabetic neuropathy can occur with long-term diabetes, usually after several years of uncontrolled high blood glucose. Glucose proteins, called glycoproteins, form in the nerves primarily those in the legs and feet. When the nerves in the feet are damaged, the brain cannot recognize pain in that area. Nerve damage from diabetic neuropathy can lead to weakness in the muscles in the legs and feet. Since the muscles work as a system, neuropathy can lead to other foot problems, such as hammertoes, calluses, bunions, and other foot deformities. These deformities are dangerous because of the risk of infection. A simple blister from a tight shoe can spell disaster
Diabetes mellitus (DM) is a pandemic that affects millions of people. The growth rate of unrecognized pre-diabetes in America is expected to rise up to 52% by 2020 (Lorenzo, 2013). As the prevalence of diabetes increases, so will the complications and burden of the disease. One of the leading causes for cardiovascular disease, renal failure, nontraumatic lower limb amputations, stroke, and new cases of blindness is DM (Lorenzo, 2013).
Uncontrolled diabetes can affect nearly every organ of the body; of which, heart disease and kidney failure are most commonly impacted. Known as diabetes mellitus, a collective term for various blood abnormalities, the term diabetes refers to either a scarcity of insulin in the body or the body’s inability to accept insulin. Though the symptoms of diabetes are manageable, many are unaware as to having it. According to the CDC report “2011 Diabetes Fact Sheet,” approximately 6 million people in the United States have undiagnosed diabetes. Undetected, diabetes can become deadly. In a recent World Health Organization report “Diabetes Action Now: An Initiative of the World Health Organization and the International Diabetes Federation,” it
7. Examine your feet. Diabetes-related nerve damage can mean that you might have minor injuries to your feet that you can’t feel. This can lead to infections and other complications. Check the soles of your feet daily. Put lotion on them at night to keep the skin in good condition. Wear comfortable shoes that fit correctly. Ask your doctor to examine your feet whenever you have an office visit.
It is estimated that 387 million people, globally live with diabetes (Phillips & Mehl, 2015). According to Medical News Today [MNT], diabetes is a metabolic disorder; which causes patients to be extremely thirsty and produce a lot of urine. Diabetes arises due to high blood pressure, due to the body not being able to produce enough insulin or because the body does not respond well to high insulin levels (MNT, 2016). There are four types of diabetes; there is the pre-diabetic stage, type 1 diabetes, type 2 diabetes and gestational diabetes. In 2014, 29 million people died due to diabetes. This equates to 1 diabetic patient dying every seven seconds due to preventable complications (including complications affecting lower limbs) caused by diabetes. It is said that 20-40% of health care costs are spent on the treatment of lower limb complications due to diabetes. The risk of a diabetic patient developing a foot ulcer is 25% and foot ulcers account approximately 85% of lower limb amputations. Diabetic complications that affect lower limbs are caused by both type 1 and type 2 diabetes (Phillips & Mehl, 2015). It is said that the World Health Organization described diabetic foot syndrome as including all possible complications in relation to the feet of a diabetic patient. Diabetic foot syndrome is defined as the ulceration of the foot, from the ankle downwards. Causes of foot ulceration include peripheral sensory neuropathy, vascular disease (ischaemia) and infection
Vascular diseases that prevent blood flow to the small vessels are common in people with diabetes. This condition can affect the feet in particular, so you should make regular visits to a podiatrist. People with diabetes also have a reduced ability to heal even minor blisters and cuts. A podiatrist can monitor your feet for any serious infections that could lead to gangrene and amputation.
Diabetic Peripheral Neuropathy (DPN) is one of the most common microvascular complications in diabetes and can result in foot ulceration, ampuation and an impaired quality of life(Carrington AL, et al 2002,Boulton AJ,et al 2004). The reported prevalence of diabetic peripheral neuropathy ranges from 16% to as high as 66%2 and its prevelance is believed to increase with the duration of diabetes and poor glucose control.(Boulton AJ.et al 2000) It’s accounts for 50–75% of non-traumatic amputations in diabetic patients.(Holzer SE, et al 1998, Boulton AJM, 1998,Malay DS, et al 2006)
Diabetes is associated with an increased risk of developing primarily vascular complications that contribute to morbidity and mortality of diabetic patients. Poor glycaemic control leads to vascular complications that affect large (macrovascular), small (microvascular) vessels or both. Macrovascular complications include coronary heart disease, peripheral vascular disease and stroke. Microvascular complications contribute to diabetic neuropathy (nerve damage), nephropathy (kidney disease) and retinopathy (eye disease).
According to Healthy People 2012 there are more then 800,000 new cases of diabetes each year, with the numbers on the rise. With this in mind, Healthy People 2012 has identified diabetes as their number five focus area. In order to reach their goal of improving the quality of life for people with diabetes they have identified diabetes teaching as their number one objective. Furthermore, in order to reduce the number of complications of diabetes, Healthy People 2012 has identified foot ulcers as their ninth objective. Through patient education Healthy People 2012 hopes to reduce the number of foot ulcers in people with diabetes, as diabetes is the number one cause of nontraumatic amputations in the United States. In order to
Diabetes is a major problem in our society today. Many people have heard about the disease; however, they do not know too much about its complications. Diabetes is a chronic, progressive and lifelong condition that affects the body’s ability to use the energy found in food (WebMD, 2016). Many new cases are confirmed every year and unfortunately, many go undiagnosed for years. Diabetes is a serious disease and need to be taking seriously. The disease can lead to many other health problems such as blindness, nerve damage and kidney diseases. The more the community understand and made aware of the seriousness of the disease, the better it can be control and or prevented.
The diabetic foot disease is the leading cause of non-traumatic lower-limb amputation and results from three common pathologies: diabetic peripheral neuropathy, peripheral arterial disease, and infection. Late complications include foot ulceration, Charcot neuroarthropathy and amputation (Turns, 2013, p.422) though another specialist like, Iraj who wrote Prevention of Diabetic Foot Ulcer, added to the most common facts: deformities and minor