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Changes seen in Diabetic Foot:
 Skin:
Dry-Dull, Dicolouration of Skin, Hair Loss, Reduced Sweating, Skin
Cracks & very important is ulceration, Infection, leading to non healing
wounds, non healing ulcers. Foot ulcers are a common complication of the
"diabetic foot". They allow a portal for infection to occur. Ulcers are
caused by too much pressure on an area and the skin just "breaks down".
They can occur under corns and callus. Healing can take a while and its
is imperative that pressure is removed from the area and good wound
dressings are used. (View
detail report by Dr. Sharmila Patil, M.D.)
Nails:
Brittle, Nail Bed Infection.
Sensory
Neuropathy: Sensations reduced, Initially vibration sensations, then
temperature, then touch sensation, then pin prick & then pressure…
sensations are lost in this sequence. The foot is especially affected by
diabetes because diabetes damages the nerves. Damage can occur to the
foot and not be detected - this is called peripheral neuropathy.
Motor
Neuropathy: Leads to abnormal foot posture, Deformed Foot due to
impairment in nerves of mussels in foot. There are 42 mussels in the
foot.
Autonomic
Neuropathy: This leads to Arterial Disease, Defective Blood Supply,
Ischemia, Leading to Foot Ulceration.
Defective
Blood Supply (Ischemia): Because of neuropathy, micro & macro
angiopathy, Accumulation of lipids in arteries resulting in to narrowing
of the arteries leading to reduced Blood Sup[ply. Diabetes also affects
the circulation. Poor circulation can affect the ability of the body to
heal when damage occurs.
Bones:
Deformities, Ostiomyelities (Infection), Lax Ligaments & Joints . Foot
contains 26 bones & 29 joints.
Gait
(Walk): Due to defective sensation, blood Supply, Pain & Ulcer, Gait
of the patient changes. Charcot's joints is another complication of
diabetes in the foot, especially if peripheral neuropathy is present -
the neuropathy cause a numbness (imagine spraining your ankle and not
knowing you have done this. You will continue to walk on it - imagine
the damage that this would do. This is what happens in a Charcot foot)
Psychological Changes: Nervousness, Depression, Lack of Confidence,
Fear of Losing Foot, Social aloofness.
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Diabetic Foot
This may not be
far off,
'if ignored' |
