Diabetes mellitus is a metabolic disorder characterized by an increase in blood glucose (hyperglycemia) that causes complications that affect both the nervous system (peripheral neuropathy), causing a decrease in sensitivity in the feet, and the vascular system (peripheral arteriopathy), causing a decrease in blood flow to the lower extremities.
Poor control of diabetes can lead to different physical and metabolic complications, such as the diabetic foot, which occurs as a result of the presence of neuropathy, ischemia and infection. The combination of these factors causes the appearance of ulcerative lesions due to microtraumas that occur in the foot.
Diabetic foot is the most common cause of hospital admission in people with diabetes and the most common cause of amputation.
From Parc Taulí, professionals work to try to reverse the damage caused by the consequences of the diabetic foot and raise awareness of the importance of taking care of the feet and controlling diabetes, to help prevent neuropathy from progressing.
"Daily prevention of diabetic foot is simple, you need to take into account three items: good foot hygiene, controlling the moisture between the toes; hydration and wearing good footwear.”, explains Maria Nicolás, podiatrist at Parc Taulí.
Although this pathology may seem to be related to older people, Maria Nicolàs warns that “Neuropathic patients are young, working-age people between 30 and 70 years old. On the other hand, ischemic patients tend to be older.".
In this sense, the professional at Parc Taulí points out that the diabetic foot “It is a very social disease. Loneliness is a factor that works against people who suffer from it.”, because diabetes can also cause diabetic retinopathy, causing vision loss and making it difficult to visually control your feet.
Treatment
Neuropathy causes the muscles to retract. The foot becomes deformed and exerts pressure in places where it should not be. This causes the toes or other parts of the foot to receive pressure in areas where they are not anatomically prepared for this function, causing injuries or ulcers. In the case of the toes, this causes them to become claw-shaped, causing injuries to the tips or backs of the toes.
Podiatrists from the Endocrinology and Nutrition service at Parc Taulí treat this pathology by relieving these pressure areas, either intrinsically (with minor surgeries) or extrinsically through relief with adhesive elements, orthoses, footwear, or plantar supports. This removes pressure from the conflicting points and distributes it evenly over the entire surface of the foot.
The most complex cases are assessed, together with other professionals from different services at Parc Taulí such as: traumatology, vascular radiology, infectious diseases, endocrinology and the complex care nursing team to decide on the most appropriate approach.