Mr. Zhou, 42, has been a long-term patient with diabetes and hypertension, but he isn't very diligent about blood sugar control. “Taking medicine and insulin every day, not being able to eat this or that, it's too painful!” As a result, he continues to smoke and drink, doesn't watch his diet, and often eats late-night snacks.
A few days ago, a friend gave Mr. Zhou a new pair of shoes. Although the toe box was a bit tight, he still wore them constantly. Upon receiving the shoes, Mr. Zhou wore them for an entire day in the park. That evening, he noticed his right big toe was swollen and black, with some skin broken. “It must be because the shoes are a bit tight. It will be fine once they stretch out a bit.” After applying some ointment, Mr. Zhou went to sleep. But by the next morning, his toe had become gangrenous and infected, so painful that he couldn't walk.
Accompanied by his family, Mr. Zhou rushed to the Hangzhou Hospital of Traditional Chinese Medicine in Zhejiang Province. After careful examination by the attending physician, Mr. Zhou was diagnosed with diabetic foot.
The worst case can lead to amputation? Diabetic foot requires immediate medical attention.
Diabetic foot is one of the most serious complications of diabetes. Diabetic patients generally have a weaker immune system, and once their feet or lower legs develop ulcers, the wounds are difficult to heal. If not promptly treated, it could lead to severe systemic infection and even endanger life. Mr. Zhou was admitted immediately due to the severity of his condition, and there was still a risk of amputation of his toes.
Diabetic foot refers to the infection, ulceration, and (or) deep tissue damage in the lower limbs of diabetic patients due to combined neuropathy and various degrees of peripheral vascular disease. The main causes include external infection, physical injury (common physical injuries include scratches, burns, frostbite, and bruises), chronic hyperglycemia, metabolic factors (such as lipid metabolism disorders), and foot vascular and skin lesions. Mr. Zhou developed a soft tissue infection in his foot due to prolonged hyperglycemia and physical injury.
Patients with diabetic foot usually first experience intermittent claudication (leg pain after walking for a period of time, requiring rest, and then the pain returns when walking again); followed by resting pain (pain at rest), then weakening or loss of the dorsalis pedis pulse, pallor of the foot, coldness of the toes, and low skin temperature, indicating poor circulation in the foot. Finally, there is arteriovenous shunting in the foot, decreased local oxygen supply, and ischemia.
It's important to note that the high glucose environment in diabetics provides a fertile ground for bacterial proliferation. Once a wound appears on the foot, it can quickly become infected and fail to heal, eventually spreading. Many severe cases of diabetic foot end up needing amputations to prevent the spread of infection, but even after surgical treatment, the surgical wound may not heal. This is why it's essential to seek medical attention immediately upon discovering diabetic foot symptoms.
The “Lingshu: Tumors and Abscesses” states: “When flesh decays, pus forms; if the pus is not drained, tendons will rot; if tendons rot, bones will be injured; if bones are injured, bone marrow will be damaged.” Without effective control, diabetic foot symptoms will continue to worsen, leading to deeper and more severe infections, potentially causing bone marrow inflammation.
Summer is a challenge—how should “diabetic friends” protect their feet?
Summer, with its higher temperatures, is a peak season for diabetic foot. For many diabetics, safely getting through summer and protecting foot health is especially important. Here are some tips:
Avoid wearing sandals.
Sandals expose the toes and can easily lead to foot injuries from collisions with hard objects. Additionally, sandals are typically harder and can increase localized pressure on the foot, leading to ulcers. Some thicker sandals lack sufficient breathability, making fungal infections more likely if the foot sweats excessively. Therefore, diabetic patients should avoid wearing sandals just for the sake of coolness during summer.
Choose appropriate socks.
In summer, wear loose-fitting socks. Avoid styles with elastic bands around the sock opening. Opt for pure cotton socks or materials that absorb sweat and breathe well. Do not wear nylon socks. Change socks frequently to keep the feet dry.
Disinfect shoes to prevent athlete's foot.
During summer, feet are prone to bacterial growth. Antifungal sprays can be used inside the shoes. Regularly patting and massaging the lower limbs can help improve circulation in the feet. Soak feet daily in lukewarm water (around 37°C), and use a soft towel to gently dry them, helping to maintain cleanliness.
Regular foot examinations.
Regularly check for any wounds, deformities, or wear on the feet. Self-test the temperature and sensation of the feet, as well as the pulse. Seek medical attention immediately if anything unusual is detected.
Editor: Zhang Zhiyuan