The Center for Disease Control (CDC) has confirmed that in 2014, 29.1 million people, or 9.1% of United States citizens had diabetes and 8.1 million of these sufferers were undiagnosed. While international diabetes data (IDF) shows the number of people with diabetes in Indonesia is estimated at 10 million and is estimated to be ranked seventh highest in the world.
Diabetes mellitus creates high multiorgan complexity. Bad conditions due to uncontrolled levels of blood sugar, cholesterol, and blood pressure will attack the inner lining of blood vessels and eventually cause complications to certain organs or parts of the body that flow through these blood vessels. One of the complications of diabetes mellitus is a condition called Diabetic Foot Disease, which is the result of two common complications of diabetes: reduced blood flow resulting from narrowed blood vessels and nerve damage.
Diabetic Foot Problems
Over time, diabetics will experience nerve damage which results in loss of sensitivity in the feet. Diabetic foot sufferers cannot feel any trauma or disturbance that occurs in their feet. In addition to disorders of the nerves, there are also disorders of the walls of blood vessels, where there is accumulation of fat which results in blockage of blood flow, most often to the legs. This blockage causes pain, infection, wounds that are difficult to heal and can even result in amputation if there is a severe infection in the leg.
Symptom
The symptoms experienced by each person can be different, but the symptoms that are often found are:
- Loss of sensation
- Often tingling
- Bullae (fluid-filled lumps) or painless sores
- Change in skin color
- Changes in skin temperature
- Wounds that won't heal
- Change in foot shape
If there is an infection in the foot the sufferer will feel:
- Fever
- shivers
- Blood sugar levels become out of control
- Shock
If it happens as described, immediately take the patient to the emergency room to get treatment.
Complications
Nerve and blood vessel disorders caused by diabetes need close attention because they can cause very serious complications, including:
- Ulcers on the feet or sores on the feet that do not heal
- Infections include skin infections, bone infections, abscesses
- Gangrene (tissue death)
- Changes in the shape of the foot (Charcot foot)
When to see the Doctor
Diabetics should routinely see a doctor who is knowledgeable about diabetes and complete care when they meet
- Changes in color and temperature of the feet
- Wounds that don't heal
- Swelling of the feet and ankles
- Pain and/or blueness or blackening of the toes
- Signs of infection
Management
Management is divided into 2: Non-surgical and Surgical
Non Surgical
- Wound care is kept clean and covered
- Immobilization device to prevent foot trauma
- Close observation of gangrene of the finger
Surgery
- Throw away dead tissue
- Amputation
- Charcot foot stabilization
- Vascular by pass or endovascular action
The surgical field of doctors who can fully treat the problem of diabetic foot disease are vascular and endovascular surgeons.
Prevention
Prevention is better than cure, this proverb is very suitable to be applied because with proper vigilance and care people with diabetic foot disease can avoid amputation.
What sufferers can do include: Controlling blood sugar levels, because high blood sugar levels make sufferers susceptible to infection. For how? taking diabetes medication and regular exercise, eating a healthy diet, and avoiding smoking and alcoholic beverages, for example, can increase your chances of avoiding diabetes. People with diabetes are patients who need awareness and obedience to maintain their blood sugar levels for the rest of their lives.
If you have diabetes, if you start to feel numbness in your feet, you have to be more careful when choosing shoes, you have to look for materials that are soft and not hard, and don't put "patches" or warmers on your feet, which can cause burns to your feet.
In addition to lifestyle changes, you should also check your feet daily, especially if you feel numb. Small wounds are very easy to see (not feel), and when left untreated they can cause infection. Washing and moisturizing your feet and removing corns and calluses properly helps protect your feet from infection. Regular trimming of toenails, wearing shoes and socks at all times, and ensuring that shoes are not too tight can also make a big difference.
In conclusion, Diabetes Mellitus is an incurable disease, but it can be controlled to reduce the incidence of symptoms and complications, by controlling blood sugar levels the quality of life of people with diabetes mellitus can be maintained as optimally as possible (LBS).
This article was written by dr. Londung Brisman Sitorus., Sp.B(K)V who is a Vascular and Endovascular Surgery Specialist at EMC Tangerang Hospital. Consult your Diabetic Foot problem with Dr. Londung who practices every Monday to Saturday from 09.00 – 13.00 WIB at EMC Tangerang Hospital.