The diabetic foot is one of the most serious and common chronic complications of diabetes mellitus, particularly when the disease is not well controlled. It is a complex clinical condition that involves alterations affecting the nerves (neuropathy), blood vessels (vasculopathy), and the skin of the foot, which can lead to the formation of ulcers, infections, and, in the most severe cases, even amputation.
Causes of diabetic foot
The main causes of diabetic foot are:
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Peripheral neuropathy
Diabetes can damage the nerves, reducing sensitivity to pain, heat, or cold. This makes it difficult to notice wounds, cuts, or irritations, which can worsen without the patient realising it. - Peripheral vascular disease (arteriopathy) Diabetes can impair blood circulation, particularly in the legs and feet. A reduced blood supply slows down wound healing and promotes infections.
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Infections
Foot injuries can easily become infected, especially if neglected. Infections in diabetic feet can be very serious and may involve deep tissues and bone.
Signs and symptoms of diabetic foot
The symptoms can vary depending on the severity of the condition, but among the most common are:
- Formation of ulcers (wounds that do not heal)
- Dry and cracked skin, with a risk of fissures
- Calluses, corns or foot deformities
- Redness, swelling or heat
- Cattivo odore proveniente da una lesione
- Pain (which may also be absent in the case of neuropathy)
- Tingling, cold feet or the sensation of "wooden feet"
- Loss of tactile or thermal sensation
Diagnosis
The diagnosis of diabetic foot is based on:
- Thorough clinical examination of the foot
- Nerve sensitivity assessment (monofilament test, tuning fork)
- Tests for blood circulation (Doppler ultrasound, ABI)
- In case of infection, microbiological analyses
- Any X-rays or MRIs to assess bone infections (osteomyelitis)
Prevention
Prevention is the key to avoiding the onset of diabetic foot and its complications. The main preventive measures include:
- Optimal glycaemic control
- Daily inspection of the feet (especially for wounds or changes in skin colour)
- Use of appropriate, comfortable and protective footwear
- Thorough foot hygiene, with regular moisturisation to prevent cracking
- Correct nail cutting, avoiding injuries
- Periodic visits to the podiatrist or specialist doctor
Treatment
The treatment varies according to the severity of the condition:
- Local treatment of wounds with specific dressings
- Antibiotics in case of infection (only if prescribed by a doctor)
- Removal of load on the foot through orthopaedic shoes or specific devices (off-loading)
- Surgical debridement of severe ulcers
- In extreme cases, amputation of part of the foot or limb to save the patient's life
When to consult a specialist
It is essential never to neglect a foot problem, even if it seems small. Promptly consulting a specialised centre for diabetic foot can make the difference between complete healing and a serious complication.
The diabetic foot is a serious condition, but it is preventable and treatable, especially if diagnosed early. Good blood sugar control, proper daily habits, and regular visits to a specialist represent the best way to protect the feet and improve the quality of life for people with diabetes.