What is diabetic foot? Know the symptoms, causes and treatments

O diabetic foot is a complication that can occur in people with uncontrolled diabetes and the condition can lead to lower limb amputation if not treated properly.

This condition is characterized by changes in the feet such as cracked skin, loss of sensitivity, numbness and, most seriously, the appearance of lesions that do not heal. It is estimated that between 40 and 80% of these lesions can result in the loss of a limb.

The symptoms of diabetic foot can vary depending on the severity of the disease. The most common are:

• Tingling or numbness;
• Burning and pain in the feet, especially at night;
• Dry, cracked skin that may bleed;
• Redness, paleness or darkening of the skin on the feet;
• Wounds that do not heal (take more than four weeks to heal);
• Presence of pus.

Symptoms begin gradually and the patient may have more than one of them.

“For diagnosis, the recommendation is to collect the clinical history, rule out other causes besides diabetes and use simple tools to assess sensitivity in the area”, explains Hermelinda Pedrosa, endocrinologist at the Brazilian Society of Endocrinology and Metabolism (SBEM), vice-president of D-FOOT International and the International Diabetes Federation (IDF).

Treatment depends on the severity of the disease and the symptoms of each patient. In general, treatment includes:

• Diabetes control: It is essential to maintain blood glucose levels to prevent the development and progression of the condition;
• Treating wounds: Foot wounds should be treated by a healthcare professional, who may use dressings, antibiotics or other medications;
• Surgery: In some cases, surgery may be necessary to remove dead tissue or divert blood flow to the feet.

“Treating a person with “diabetic foot” requires team monitoring with an interdisciplinary focus, as joint care by a general practitioner, endocrinologist, infectious disease specialist, vascular surgeon, orthopedist and nurse is crucial,” adds Hermelinda.

According to the experts interviewed for the report, around 80% of amputations that occur due to diabetic foot can be prevented. To this end, identifying people at risk of developing ulcers (lesions) should be done as part of a health prevention policy.

“It is important for people with diabetes to be evaluated for neuropathy and arterial disease annually, which is why check-ups are recommended to assess the eyes, kidneys, heart and brain. Many patients discover complications when they already have an ulcer, and these are not simple wounds – they require prompt and appropriate treatment by a team. In this way, amputations, which occur in between 40 and 80% of people with diabetes, can be prevented,” adds Hermelinda.

What is diabetes and how to prevent diabetic foot

Data from the Brazilian Diabetes Society indicate that in Brazil there are more than 13 million people who have diabetes, which represents 6.9% of the population.

Diabetes is caused by insufficient production or poor absorption of insulin — the hormone responsible for regulating blood glucose levels and breaking down these molecules into energy.

The disease can cause an increase in blood glucose levels and high levels can lead to various complications in the heart, arteries, eyes, kidneys and nerves.

To prevent diabetic foot, one of the complications that diabetes can cause, it is recommended to keep blood glucose levels under control.

“Prevention involves good glycemic control, assessing the condition of the feet at each appointment and taking care, such as avoiding tight shoes, not walking barefoot and drying well between the toes after bathing, to avoid mycoses”, explains Ana Cristina Belsito, head of the Endocrinology Service at Hospital São Vicente de Paulo (HSVP-RJ).

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