2023-12-31 07:00:21
According to High Authority of Health, between 15 and 25% of diabetic subjects will develop a diabetic foot ulcer during their lifetime. Each year in France, around 10,000 amputations are carried out following diabetic foot complications. There French Language Infectious Pathology Society (SPILF) has just published its latest recommendations relating to the management of diabetic foot infections. Lighting.
Diabetes mellitus and diabetic foot
What is the diabetic foot ? What is the connection between diabetes and the foot? Chronic diabetes mellitus, whether type 1 diabetes or type 2 diabetes, exposes patients to multiple complications. The abnormal and repeated elevation of blood glucose levels, hyperglycemia, is responsible neurological and vascular damage, progressively irreversible. The foot is not immune to these attacks and diabetic patients simultaneously present a loss of sensitivity in the feet (they feel less pain) and impaired blood circulation (blood circulates less well in the foot).
From these mechanisms, arise different complications of diabetic foot :
Diabetic foot infections: often benign at first, they can progress to more severe infections in diabetics; Plantar perforating pain which combines the formation of horns at the support points of the foot, deep hematomas and ulcerations of the skin.
In diabetics, wounds and infections of the foot can spread quickly and have difficulty healing. Rapid diagnosis and appropriate treatment, often long, is necessary to prevent recourse to amputationwhich unfortunately still remains relevant in a certain number of cases.
Read also – Coffee consumption, a risk factor for diabetic nephropathy?
New recommendations from the SPILF
Learned societies regularly formulate recommendations for diagnosing and treating wounds and infections of the diabetic foot, with the aim of limiting the use of amputation. The recommendations proposed at the end of 2023 by the SPILF update their previous recommendations dating from 2006. They define the modalities for:
Management of diabetic foot infections; Microbiological diagnosis depending on the stage of the injury; Antibiotic treatment regimens: first-line and second-line treatment, dosages and transition to the oral route; The use of short antibiotic therapies in certain defined contexts.
These recommendations allow all healthcare professionals supporting diabetics to optimally manage diabetic foot ulcers. These patients can also be followed in reference centers for wounds and healing, which exist in different French regions. Referred by their treating physician or diabetologist, patients benefit from a team specializing in the management of wounds, particularly diabetic feet, in these centers.
Read also – National Foot Health Day this Thursday, June 16
Taking care of your feet to prevent diabetic foot
Diabetic foot and its complications are not inevitable for diabetics. Throughout life with diabetes, take care of your feet and have them monitored regularly by professionals can help limit the risks. Here is some reflexes to adopt :
Adopt good hygiene for your feet, toes and nails: avoid maceration, wear cotton socks and change them regularly, dry your feet well following showering, treat skin fungus; Check and monitor the condition of your feet: if you are not able to do this, ask a loved one. And every year, remember to make an appointment with a podiatrist for a more in-depth check-up; Take appropriate care of any injury: friction, wound, scratch, etc. Consult if in doubt; Avoid using certain hygiene or comfort techniques or utensils, such as certain nail clippers or hot water bottles. A simple injury from cutting your toenails can develop into a diabetic foot infection; Do not walk barefoot and choose shoes adapted to your body type, your walking conditions and the health of your feet; And of course control your diabetes: glycemic balance remains the best weapon once morest the complications of diabetes. Read also – Gastroparesis, a neurological complication of diabetes
Estelle B., Doctor of Pharmacy
Sources
– Clinical practice recommendations for infectious disease management of diabetic foot infection (DFI) www.sciencedirect.com. Consulté le 18 décembre 2023.
– Diabetic foot and its infections. www.federationdesdiabetiques.org. Accessed December 18, 2023.
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