Diabetic Foot Syndrome (DFS) Diabetic Foot

What Is Diabetic Foot Syndrome?

Diabetic foot syndrome (DFS) occurs due to inadequate oxygen supply, or oxygen-saturated blood, to the foot. Excessive blood glucose levels in line with diabetes mellitus type 1 or diabetes mellitus type 2 cause sugar molecules binding to important proteins of the body and impair their function. As a result, the layers that line the blood vessels from the inside thicken, creating constrictions through which less blood can be transported. In addition, the sugar molecules damage the nerves running in the foot (diabetic neuropathy), which leads to a reduced sensation of pain and temperature.

What Are the Symptoms of Diabetic Foot?

If the foot nerves are damaged (diabetic neuropathy), the following symptoms may occur:

• Dry skin
• Redness and swelling
• Reduced sensation of pain and temperature
• Numbness
• Sensitivity to touch
• Skin defects (ulcerations)
• Charcot's foot
• Claw toes

Damage to the foot’s blood vessels results in cool, pale skin and foot tissue dying off (necrosis).

How Is Diabetic Foot Syndrome Treated?

The goals of therapy are to prevent disease progression and to allow the eventual improvement of symptoms. First and foremost, this includes proper treatment of excessively high blood sugar levels (diabetes therapy). Besides, foot care and pressure-relieving footwear can help alleviate symptoms and allow the foot to heal.

Revascularization therapy (PTA, bypass of a foot artery ) plays an important role, which refers to cleaning or unblocking the blocked foot blood vessels; it can be done using a wire inserted into the vessel and gently clears out the vascular constrictions. If foot nerves are affected, particular medications may be used for therapy.

Which Specialists Are Appropriate for Treating Diabetic Foot Syndrome?

The typical specialist for diabetic foot syndrome is the endocrinologist or diabetologist, specializing in the various forms of diabetes and its secondary diseases. For vascular surgery (e.g., bypass), specialists in vascular surgery should be contacted.

How Can Diabetics Prevent the Diabetic Foot?

It is primarily necessary to control diabetes and avoid high blood glucose levels optimally o prevent diabetic foot syndrome.

Daily inspection of the feet for injuries or changes plays an essential role in preventing diabetic foot. Good foot care by a professional can also help prevent injuries and detect the first signs of diabetic foot syndrome. The German Society for Vascular Medicine warns:

"More than 30,000 amputations are still performed annually in Germany as a result of diabetic foot syndrome - take the time to care for your feet!"

Also, a healthy lifestyle is recommended. Accordingly, nicotine and excessive alcohol consumption should be avoided. Sufficient exercise and a healthy diet (Mediterranean diet with plenty of fish and vegetables) also reduce the risk of developing a diabetic foot.

Sources:

• http://www.diabetes-ratgeber.net/Diabetisches-Fusssyndrom
• http://www.gefaesschirurgie.de/patienten/diabetischer-fuss.html
• Karges, Al Dahouk: Innen Medizin; Springer Verlag 2011