Diabetic foot syndrome: treatment and natural remedies

What should you do? Treatment of diabetic foot syndrome

There is a treatment for diabetes, but it can only reduce the symptoms with medication.
Various medications are available to alleviate the pain.
The doctor prescribes nonsteroidal anti-inflammatory drugs and painkillers to reduce discomfort
and inflammation.

The doctor recommends the patient rest and reduction of foot movements during periods of
pain.
If diabetes and foot pain increase over time, the level of sugar in the blood must be checked regularly so as not to feel worse.
If the blood sugar level is within the normal range, complications are prevented before the first symptoms appear and the already existing problems can be treated.

First of all, it is necessary to contact a doctor and initiate effective treatment against diabetes.
Medication can be very useful, but the most important thing in the treatment of diabetes is a healthy lifestyle and a balanced diet.

Antibiotic therapy is important in case of infection. To do this, the doctor prescribes the appropriate medicine depending on the patient’s other diseases.

Natural remedies for diabetic foot syndrome

Hyperbaric therapy has not yielded good results in scientific studies.
Among the best remedies are diabetes diet and regular physical exercise.

Nursing assistance
Depending on the size and depth of the ulcer, the patient needs frequent (usually daily) care assistance when changing bandages and choosing suitable footwear.
If the shoes are too tight and they cause the formation of blisters, this can lead to the formation of ulcers.
With superficial ulcers, it is enough to change the dressing more often and check the wound for infection.

Splints, insoles and shoes in diabetic foot syndrome

To avoid friction on the pressure wounds, you should wear special footwear.
Insoles for the diabetic foot prevent injuries that develop as a result of friction in the shoe interior.
A cause of friction and pressure is also the knuckle foot.

Matching insoles:

1. Prevent excessive pronation
2. Distribute the body weight over the entire surface of the foot
3. Have an “undermined” area in the ulcer area

Shoes for diabetic foot syndrome
The shoe must not have a seam in the area of the pressure points and must be made of elastic material.
With a mild diabetic foot, the leather upper part must be flexible and cuddly so that it can adapt to foot deformities (such as hallux valgus) and thus avoid further friction.

In more severe cases, a boot is used to avoid overloading on the forefoot (on the metatarsal and toes).ù
With open ulcers, the footwear is open at the front to allow the foot to breathe.

Lifting the leg
In order to avoid pressure on certain foot areas, you can make a knee-high shoe (tutor), which allows a relief of the ulcer zones.

Revascularization in diabetic foot syndrome

There are surgical procedures that allow better blood circulation and thus prevent amputation.

Angioplasty is performed to open blood vessels and allow the blood to circulate freely.

1. A catheter with a balloon is inserted into a blood vessel on the leg or foot.
2. The balloon is inflated to open the narrowed area and a metal tube (stent) is inserted into the blood vessel.

Most patients only stay in the hospital for one night during a procedure like this.

Bypass surgery, in which a heart surgeon takes blood vessels from one part of the body, which are then inserted in place of the closed vessel on the leg to restore circulation, is performed in the operating room.
This is an extremely invasive procedure that requires hospitalization and a longer recovery time.

Amputation for foot problems

Gangrene can be caused by an ulcer on the diabetic foot.
The ulcer is an open wound that can develop on the feet of diabetic people.

Circulatory problems lead to a high risk of infection.

• The infection eventually leads to a lack of blood flow, which causes gangrene, i.e. necrosis (death of cells) of the body’s tissues.
• The most complicated problem is that of the feet. If the ability to feel the toes of the foot is lost, they can often become sore without the person noticing.
• Even from a small incision, an ulcer can develop, which then becomes a serious infection.
• Foot infections can spread over the entire leg
• Sometimes the infection is so pronounced that the doctor amputates the toes of the foot, foot or parts of the leg
• Amputation is the last treatment measure. The doctor decides to amputate the limbs only if all other medical remedies have failed.
• The doctor saves most of the foot or leg; he must be aware that a surgical operation is a definitive intervention.

When is amputation necessary?
Infection and dead tissue continue to spread over time and amputation is required to save the patient’s life.
The surgeon may remove the entire lower limb, a foot or a toe.
The doctor removes the dead tissue and replaces it with skin grafts.
The patient remains in hospital for up to eight weeks to heal the wounds.

Amputation surgery for diabetic foot syndrome

Amputation is performed under general anesthesia or under epidural anesthesia (regional anesthesia); the patient does not feel any pain during the operation.
The diseased part of the leg is replaced by a prosthesis: the autonomy that the patient will have depends on the size of the amputated part of the lower limb.
The surgeon performs many procedures to improve the range of motion of the stump and reduce the risk of infection:

The procedure consists of:

• The stump is covered with soft tissue.
• The surgeon attaches the muscles to the bone to allow the stump a correct amplitude of movement.
• T he doctor closes the wound with sutures and staples.

After the procedure, the healing process continues to be accompanied in the hospital.

1. In the first few days, fluids, oxygen and nutrients are administered.
2. The doctor connects the stump with an elastic bandage.
3. A drainage tube leads out of the wound to drain excessive fluids from the surgical tissue. This tube helps reduce bruising and swelling.
4. The bandage should not be changed during the first five days to avoid the risk of infection.
5. In the case of spinal anesthesia, the nurse places a urinary catheter over the duration of the surgical procedure.
6. The limb on which the amputation took place is very painful. It is therefore recommended to take painkillers if necessary.

Rehabilitation after amputation in diabetic foot syndrome

After surgery, the patient needs rehabilitation treatment. He must learn to return to daily life without a body part. The amputated limb can be replaced by a prosthesis.
The physiotherapist helps the patient to use these aids correctly.
The rehabilitation team makes a whole series of home adjustments to help the
individual to resume normal daily activities.

Some amputees feel pain in the amputated limb. This pathology is known as phantom pain.
Physiotherapy can be very helpful here to maintain mobility of the lower limbs, to improve posture (which is incorrect due to incorrect foot load) and to prevent pain in the non-amputated joints (for example, the knee).

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