What are the diagnostic criteria for diabetic foot? What is Diabetic Foot?

1) Medical history taking.

It is necessary to understand the duration, mode and other complications of diabetic patients, and identify the cause, duration, degree and progression of foot ulcers;

2) Physical examination.

Pay attention to the appearance, extent, depth, temperature, and odor of the ulcer surface, and determine whether the foot is deformed, swollen, soft-tissue infection, or osteomyelitis. Check the condition of the contralateral limb and whether the shoes and socks are appropriate;

3) Ancillary examinations.

1.Neurological examination.

The goal is to find out if the patient still has protective neurosensory. The simplest and most commonly used method is to use a special 10 grams of nylon filament, one end touching the patient's big toe, heel and the outside of the front soles, press the other end of the nylon filament with your hand, and gently apply pressure to bend the nylon filament, the soles of the patient's feet or toes can feel the nylon filaments on the soles of the feet at this time, it is normal, otherwise it is abnormal. A tuning fork is also used to check how the patient feels about vibration.

2.**Temperature check.

Diabetic foot examination method (4 photos) examines ** the sensation of temperature changes, whether the response to neurological function is impaired. Qualitative and quantitative examinations. Qualitatively, that is, the tuning fork or a thin stainless steel stick is placed in a cup of warm water, and after being taken out, the ** sensation of different parts of the patient is measured, and at the same time compared with normal people.

Quantitative tests require the use of instruments.

3.Pressure determination.

By measuring the pressure in different parts of the foot, the patient is known to see if there is an abnormal pressure in the foot. Subjects are usually placed on a flat plate with multiple pressure sensors, imaged by scanning, and analyzed on a computer.

4.Examination of peripheral blood vessels.

The easiest way is to feel the pulse of the instep or posterior tibial artery with your hand to understand the macrovascular lesion of the foot, and the loss of fluctuation indicates a serious macrovascular lesion that requires further investigation.

1) Vascular ultrasonography: to determine whether the blood vessels are stenosis or occlusion.

2) Ankle artery-brachial artery blood pressure ratio: reflects the blood pressure of the lower limbs and the state of blood vessels, and the normal value is; Mild ischemia, moderate ischemia, severe ischemia. Patients with severe ischemia are prone to gangrene of the lower extremities (or toes).

3) Angiography: to understand the degree and location of vascular occlusion of the lower limbs, and to provide a basis for amputation plane or vascular bypass surgery.

4) Transcutaneous oxygen partial pressure measurement: reflect the microcirculation state, and at the same time reflect the blood supply status of the surrounding arteries.

5) Hemorheological examination: whole blood viscosity, plasma specific viscosity, reduced viscosity of whole blood; erythrocyte aggregation index, erythrocyte stiffness index; Plasma fibrinogen content determination.

5.Examination for ulcers and infections.

Osteomyelitis should be considered when a probe is used to probe an ulcer suspected to be infected, if sinus tracts are found and bone tissue is probed; At the same time, a probe is used to take a sample of the deep ulcer for bacterial culture to increase the specificity of culturing infected bacteria. Deep infections or bone lesions can also be identified by plain x-rays, isotope scanning, or magnetic resonance imaging.

6.Examination of Charcot arthropathy.

Patients with a long history of diabetes mellitus may have complicated Charcot arthropathy. Specialist examination and diagnosis are required.

1. All diabetic foot is one of the complications of diabetes, which is the lesion of the blood vessels and nerves of the foot far from the ankle joint of diabetic patients, resulting in insufficient blood supply to the foot, paresthesia, and ulceration and infection symptoms, and in severe cases, it can affect the muscles and bones, resulting in tissue necrosis and even amputation. According to the degree of foot ischemia, it can be divided into ischemic type, neurological type and neuroischemic type.

The ischemic type is manifested as cold lower limbs, difficulty walking, intermittent claudication, resting pain and other symptoms, and later may appear ulceration and dry gangrene. The neurological type is mainly manifested as paresthesia in the lower limbs, which may have numbness and pain, but the temperature of the foot ** is normal or elevated, and the ulcer is often accompanied by infection after the ulcer, and the ulcer is easy to heal after the burden of the affected foot.

Neuroischemic type is between neurological type and ischemic type, also known as mixed type, which is the most common in China, and has both lower limb ischemic symptoms such as difficulty walking and neurological symptoms such as peripheral paresthesia. Peripheral vascular disease is an important factor affecting the recovery of diabetic foot. The clinical manifestations can be found by the color and temperature, dorsalis pedis artery pulse, etc.

If it is not far from Shenzhen, you can go to the Qingshuihe Armed Police Frontier Corps Doctor.

Diabetic foot**.

1. First of all, it can be judged whether it is diabetic foot and whether the color of the flesh around the wound has changed, such as darkening and blackening.

2. First clean up the necrotic tissue around the lesion, wash it with saline, then wash it with hydrogen peroxide, and then wash it with saline, and then spray the affected area with "recombinant bovine alkaline fibroblast growth factor external solution", then apply moist burn ointment, and fix it with gauze, once a day.

3. Diabetic patients should be controlled on an empty stomach of less than 6 and less than 10 after meals.

4. Appropriately combine some anti-inflammatory and nutritional peripheral nerve drugs.

5. Supplement nutrition, trace elements, etc.

6. This is a long process, ranging from three to five months to more than half a year.

One hospital has an internal medicine or one surgery. Too far can be used in the following ways.

For complications caused by diabetes, you should avoid touching hard parts of the body and avoid mosquito bites. Lifelong hypoglycemic drugs are required

X-ray examination: X-ray examination is mainly to check the foot bone, whether there is osteomyelitis, whether there is bone cortical destruction, whether there is dead bone formation and other phenomena.

**Temperature check: The temperature tester can be clearly recorded, and this inspection is mainly to compare the affected foot with the healthy foot.

Neurological examination: This examination method is to use monofilament to contact ** to observe whether the patient has a protective feeling, so as to indirectly determine whether the patient has neuropathy and the degree of neuropathy.

Examination of blood vessels: The examination of blood vessels is mainly to judge the blood of the affected limb (toe) through this examination, which is very important for the prognosis of this disease.

In general, the diabetic foot test has the following points.

1.Physical examination. The frequency of physical examinations should be done at least once a year, and more frequently for people at high risk of diabetes. Through the inspection, the main contents that need to be observed and recorded are: abnormal gait, wear and tear of shoes, gold, crown.

Bone and department and whether there is a foreign body protruding into the shoe, vascular pulsation, hair growth, skin temperature and capillary refill, deformity and tissue destruction of the foot and heel, the location and size of the ulcer, and the presence or absence of edema or inflammation. The stability of the joints and the strength of the muscles should also be checked.

2.Comprehensive neurological examination.

Examination of reflexes, motor and sensory function. Qualitative sensory examinations, such as light touch, two-point discrimination, pinprick sensation, and proprioception. Quantitative sensory testing, most commonly pressure testing using semmes-weinstein nylon monofilaments.

3.Vascular examination.

The most commonly used non-invasive test is arterial Doppler ultrasound, which can be performed at the hospital.

All diabetic patients should do B ultrasound at least once a year to see if the blood vessels are blocked. If it is blocked, you should go to a specialist as soon as possible, whether you can dilate the blood vessels, whether you can use some drugs to make the blood unblocked, and there is also a test that is the examination of the sensation, whether the feeling is normal, if you find that the sensation is dull, then we can use some neurotrophic drugs to go early.

Diabetic foot is mainly to do a vascular examination to see if there is a blockage in the degree of blood circulation, and to check how the mental microcirculation is, and whether there are any complications of diabetic foot.

The daily diabetic foot prevention examination usually uses pinprick test, nylon filament pressure test, tuning fork vibration test, ankle and knee reflex test, and temperature rod temperature sense test. The above inspection methods are convenient and fast, but they can only be judged empirically, and the measurement is not accurate enough to obtain definite data.

Because of the high risk and high insidiousness of diabetic foot, if potential patients ignore it or the above devices fail to effectively confirm its arrival, the terrible consequences are unbearable for ordinary people.

Therefore, it is necessary to introduce a diabetic foot screening box to accurately check what stage the patient's diabetic foot is located in, and whether it needs to be replaced.

Nowadays, the probability of diabetes appearing around us is also increasing. Diabetes is a disease that has a big impact on people's lives. Its complications have a serious impact on people's lives, and diabetic foot is a manifestation of diabetes.

It is one of the more common complications of diabetes. And the harm is very great, and in serious cases, it can even lead to amputation or death. Diabetic foot has a high incidence and is difficult to prevent. Therefore, as a diabetic, it is important to check your feet frequently.

First of all, you should take good care of your feet, and you should wash your feet frequently every night. Feet should be washed with lukewarm water, and water with a water temperature of 38 degrees or below 37 degrees will be fine. After washing your feet, you should carefully observe whether there are any cracks or wounds in your feet.

Even small wounds need to be vigilant and should be checked by the hospital in time.

Secondly, look at the color of your feet and feel the temperature of your feet with your hands. If there are abnormal changes, you should be vigilant. A subtle change can be an indication of the development of diabetic foot.

Finally, if there is some pain in the foot, or the pain is relatively dull, it is also necessary to pay special attention. Because it is likely to be related to neuropathy of the feet. In addition, if you are not comfortable looking in the mirror, you can prepare a mirror to observe the soles of your feet.

Foot check-ups must be frequent. Feel the temperature of your feet and check if there are any noticeable changes in your feet, whether they have suddenly become fat or suddenly thin. All in all, when there are some changes in your feet, you must see a doctor in time to pay attention to your condition.

Otherwise, if you get diabetes, the situation will become more and more serious, and finally you will regret the amputation.

Diabetic foot is a foot infection caused by nerve and vascular lesions of the lower extremities in diabetic patients. However, there are generally three types of the disease. One is called neurological, the other is vascular, and the other is mixed.

However, there is no cure for this disease yet, but I believe that this problem will be solved in the future. Because China's science and technology have been constantly improving.

Diabetic foot is a foot disease caused by the lesion of the vascular nerves of the lower limbs caused by the patient's diabetes, and there are three types of diabetic foot, one is vascular diabetic foot, the other is neurological diabetic foot, and the last is mixed diabetic foot.

There are vascular, neurological, and mixed, which are broadly divided into these types. This is because the patient has diabetes, so there is a problem with the blood vessels in the lower limbs, resulting in lesions.

There are three main types of diabetic foot, one is the vascular type of diabetic foot, the other is the neurological type of diabetic foot, and the third is the most common mixed type of diabetic foot.

It refers to the fact that the patient has diabetes, and in this condition, the nerves in the feet have some lesions. Including vascular, neurological, mixed.

1. Diabetes mellitus is a systemic chronic progressive disease, mainly due to the inability of pancreatic islet cells to secrete insulin normally, resulting in absolute or relative insufficiency of insulin, which causes the metabolism disorder of sugar, fat and protein in the body, which is mainly based on glucose metabolism disorders, resulting in the inability to synthesize liver glycogen and muscle glycogen, resulting in a series of symptoms such as increased blood sugar, urine glucose and reduced glucose tolerance.

2 Diabetes symptoms (typical diabetes symptoms include polydipsia, polyuria, and unexplained weight loss) plus blood glucose checks:

Random blood glucose (refers to blood glucose at any time within 1 day, regardless of the time of the last meal);

or fasting blood glucose (defined as fasting for at least 8 hours without caloric food);

or a 2-hour blood glucose after glucose load can be considered diabetes.

Note: If you have no symptoms of diabetes, you need to repeat the blood glucose measurement on another day to confirm the diagnosis.

Type 3 diabetes mellitus is more likely to occur in young adults, generally less than 30 years old, with a sudden onset, obvious symptoms of three more and one less (obvious symptoms of polydipsia, polyuria, polyphagia and weight loss), high blood sugar levels, many patients have ketoacidosis as the first symptom, low serum insulin and C peptide levels, and ICA, IAA or GAD antibodies can be positive. Usually, oral hypoglycemic drugs alone are ineffective, and insulin is required**.

Type 4 diabetes is common in middle-aged and elderly people, among whom obesity has a high incidence and is often accompanied by hypertension, dyslipidemia, arteriosclerosis and other diseases. Type diabetes mellitus generally has no obvious symptoms at the beginning, no symptoms in the early stage, or only mild fatigue, thirst, and no obvious increase in blood sugar, glucose tolerance test is required to confirm the diagnosis. Serum insulin levels are normal or elevated in the early stages and low in the late stages.