Diabetes leg pain treatment. Complications of diabetes - leg disease

Diabetes mellitus is noted increased content glucose in the blood. Such a violation can provoke pathological changes in the vessels and nerves of the limbs. It is not uncommon for diabetes to cause leg pain. Particular attention should be paid to their health with this diagnosis. Why does this happen and what to do if your legs hurt due to diabetes - we will consider further.

Damage to nerve tissue caused by diabetes is called neuropathy, and impaired vascular health is called angiopathy. Due to the composition of the blood with a high sugar content, the nerve endings located in the feet are damaged. There is a loss of sensitivity, and the pain that indicates damage is dulled. Work deteriorates vascular system, especially small capillaries. All these signs are reflected in the skin of the extremities, which loses elasticity.

Change appearance legs with affected skin (due to poor condition nerve endings and blood vessels) the disease is not limited. In addition to the appearance of cracked feet and dryness, diabetes affects the joints. Arthropathy develops. Wrong exchange glucose in tissues disrupts the condition of cartilage, as a result of which diabetics complain of joint pain. Unpleasant sensations appear primarily when walking.

The first symptoms of arthropathy appear in the form of swelling of the foot. There is redness. Over time, the toes become deformed, and the swelling becomes stable and noticeable. This is very dangerous, because the likelihood of dislocations and fractures increases, and the foot changes. If your legs hurt due to diabetes, treatment should begin with identifying specific signs.

How do legs hurt with diabetes? Damage to the nerve endings that accompanies diabetes manifests itself in the form of pain when walking and at rest. Painful phenomena in the legs are often observed at night. At first their intensity is moderate, but then they affect the lifestyle, intensifying. Legs with diabetes mellitus are bothered by pain in the feet, legs, and with arthropathy in other joints. Sometimes seizures occur general weakness limbs. The sensations of tingling or numbness are also not pleasant. Sensitivity decreases, swelling appears. Not only the skin, but also cartilage tissues suffer from insufficient metabolism. This is fraught with lesions accompanied by pain reactions. Severe pain in diabetes develops over time.

How to correctly determine the cause of violations

These signs are not always associated with diabetes; sometimes it is a consequence of disease of the joints, veins, nerves or osteochondrosis. Your doctor will help you understand the cause by prescribing an examination. Once the diagnosis is made, appropriate treatment will be prescribed. If the cause is related to diabetes, then medications for other diseases will not help relieve pain. But a concomitant diagnosis of heart or joint disease can cause the same symptoms. Interrelated symptoms occur. For example, diabetes affected the kidneys and this caused swelling in the legs.

“Diabetic foot” - the first symptoms

The term “diabetic foot” is usually used to refer to the entire complex of changes observed in the foot due to diabetes. A person suffering from this disease does not always consider complications to be a consequence of the main diagnosis, not noticing impairments in the health of the limbs. But there are quite a few symptoms of diabetes that appear specifically on the legs. You should familiarize yourself with them from the very first cases of detection high content sugar in blood test. Then you can promptly treat pain in the legs due to diabetes.

Symptoms of unhealthy changes in the legs that accompany sugar sickness are as follows:
⦁ the skin becomes dry and flaky;
⦁ there is itching;
⦁ change in pigmentation of the lower leg;
⦁ calluses (otherwise known as hyperkeratosis);
⦁ men lose hair growing on their legs;
⦁ the shape of the nail changes, and it itself thickens;
⦁ swelling in the ankles;
⦁ pale and cool skin on the legs (or with bluish tints);
⦁ fungal infection of the feet and nails;
⦁ numbness of the legs;
⦁ pain;
⦁ sensitivity is impaired, both temperature and when touched, influenced (tactile).

When the above symptoms appear, it is necessary to pay close attention to them, otherwise the consequences may be disastrous.
This:
⦁ persistent ulcers not accompanied by pain;
⦁ boils;
⦁ joint disorders - arthropathy;
⦁ pus on the bones - osteomyelitis;
⦁ gangrene of the limbs.

Medical examination for diabetic feet

To prevent serious consequences, timely consultation with a doctor is very important. Diabetics are examined for complications in the leg area by an endocrinologist and a surgeon, a vascular specialist. The progression of the disease is assessed and corrective changes are added to diabetes treatment. Neuropathy and angiopathy require special treatment. In the physiotherapy room, they give visual recommendations on foot care and perform hygiene: treatment with creams, cutting off calluses. "Cabinet diabetic foot“It is necessary to visit once a year if diabetes is initially diagnosed, even if you feel normal.

The pulse of the legs is examined and reflexes are checked. Vessels are examined ultrasonic methods. In addition, check:
⦁ tactile sensitivity;
⦁ temperature and vibration sensitivity;
⦁ perform electrical neuromyography.
The presence of symptoms is the basis for seeking medical advice. The cause is even, at first glance, minor inflammation. You should not postpone your visit for more than a day.

Feet care

It is required to follow a number of rules that are not difficult to follow, but are very important.

Examination of the feet daily in the area of the feet, soles, and between the toes. To make it easier to do this yourself, use a mirror. You should pay attention to scratches and cracks that could become infected.
Washing your feet every day with regular soap. The water should be at a comfortable temperature, warm. It is especially important to keep between your toes clean. After washing, dry your feet with a towel, being careful not to scratch the skin.
If peeling, fungi, plaque, accompanied by itching and redness are detected, contact a dermatologist. An antifungal agent will be prescribed.
You should also inspect your shoes every day for defects that could cause damage to your foot or cause calluses.
Nails are trimmed carefully and treated with a file. The corner of the nail plate should not cut into the skin after regrowth or touch nearby fingers.
If your feet are cold, wear socks.
It is better not to take hot baths. After all, it is possible to have a violation of sensitivity and, as a result, a burn. Monitor the temperature of the water when taking a bath.
It is better not to use alcohol and brilliant green to lubricate the wound. Wanted medicated creams, hydrogen peroxide 3%. Betadine, miramistin and bandage are also applicable.
Dry skin can be eliminated by lubricating your feet with a rich, nourishing cream after washing. Creams with vegetable oils are recommended. The keratinized skin is treated with pumice.
Shoes should be comfortable and of the appropriate size, and if the foot is deformed, orthopedic shoes should be used. Wear clean socks or tights.
Walk for half an hour every day, as well as foot massage and gymnastics.
A complete cessation of bad habits is required: smoking, overeating. You need to maintain your sugar levels within normal limits using a diet.

Treatment

Modern medicine is not yet so easy to solve the problem of foot diseases in diabetes. If you experience pain in your legs, you should immediately visit a doctor. Only timely prescribed treatment can avoid severe complications. Firstly, it is a relief for ourselves pain. Measures are then taken to permanently eliminate pain while maintaining full mobility. Prevention measures should also not be neglected. After all, the disease can result in amputation of toes, loss of a foot, and even the loss of an entire limb.

The need for treatment and prevention

The cause of pain is atherosclerosis, when the lumen in the vessels becomes narrow, which interferes with blood flow. In addition to the lack of oxygen in the tissues, foot pain in diabetes mellitus can occur over time due to damage nerve fibers. Impulses stop being transmitted in a normal way and loss of sensation occurs. As a result, a person misses the moment of detecting significant damage affecting cartilage, joints and bones.

Considering these two ways of developing the disease, you need to monitor your feet in time according to the above rules. Low vascular permeability is very dangerous, painful in the legs with type 2 diabetes. Not only capillaries, but also peripheral arteries can become clogged. Whatever the stage of diabetes development, pain signals still encourage the patient to seek timely help.

An experienced doctor can correlate the condition of the arteries in the legs with their pulse, detecting abnormalities. But a significantly reduced blood beat is observed only when the lumen of the artery is blocked by 90%, which is an almost irreversible situation, often requiring surgical intervention. Modern sensitive equipment is used to detect leg disease in the initial, middle and other stages.

Medicines

By controlling your sugar levels and responding to discomfort in a timely manner, you can prevent the development of leg pain syndrome. Of course, the use of drugs is an extreme case. Doctors advise starting with a light medication, increasing the intake as needed. If the pain is mild, anti-inflammatory drugs such as ibuprofen and acetaminophen are suitable. But if you experience severe pain, you need to use more active means. These are anticonvulsants with a non-narcotic effect, as well as antidepressants used for neuropathy due to diabetes.

Among the drugs used for anticonvulsant effect, neurontin and pregabalin are known. The second type of drugs is directed against depressive states patient resulting from constant pain. By increasing the amount of serotonin and norepinephrine, these drugs reduce discomfort. Both types of drugs can increase sugar levels, so it is necessary to control this indicator.

Local treatment

Creams containing an analgesic are used to target the area of pain. Doctors recommend using them with medications and procedures. So the lidocaine contained in the patch is applied to the sore spots for a period of 12 hours. Often, the doctor prescribes gels containing ketoprofen or ketamine. Such treatment is not complicated by side effects, as with medications. They almost never enter the bloodstream.

Massage and other methods

If there are no wounds or damage to the feet, a regular massage is recommended. First, take a warm foot bath and apply cream to the soles of your feet. Then a massage is performed with the fingertips. Using gentle pressure, you need to move from the toes to the middle of the foot and the heel. The massage ends with kneading the Achilles tendon.

The acupuncture method has been successfully used. Using the finest needles inserted into certain points, stimulation is performed energy channels. By freeing areas of the body from stagnant energy, acupuncture not only relieves pain, but can completely stop it and relieve inflammation.

An electrical device, a myostimulator, is another tool that reduces susceptibility to pain. It is used for mild pain.

Conclusion

Diabetes is dangerous for the lower extremities, which bear heavy loads when walking. U quite a large percentage the number of people with this diagnosis occurs similar problems- sore legs due to diabetes. The possibility of their appearance is especially high with age. We must remember about the serious complications that threaten the body if the disease is advanced. But also know the fact that there is a real opportunity to maintain normal health and take advantage of it.

Persistent increases in blood sugar (glucose) levels can be associated with serious complications in people with diabetes.

Feet are particularly at risk. In people with diabetes, two complications called diabetic neuropathy and disease can cause damage to the foot (and other parts of the body). peripheral vessels.

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Chronically elevated levels Sugars associated with uncontrolled diabetes can cause nerve damage, which interferes with the ability to sense pain and temperature. This so-called “sensory diabetic neuropathy” increases the risk that a person with diabetes may not notice problems developing in his or her foot.

About 10% of patients with diabetes develop leg ulcers, which are a consequence of peripheral vascular disease and nerve damage. People with diabetes may not notice sores or cuts on the leg, which in turn can lead to infection. Nerve damage can also affect the function of the foot muscles, leading to misalignment and injury.

Diabetes is associated with poor circulation (blood flow). Inadequate blood circulation increases the time it takes for wounds and cuts to heal. Peripheral vascular disease refers to impaired circulation in the arms and legs.

Poor blood flow increases the risk that the infection will not be cured. This, in turn, increases the risk of developing ulcers and gangrene, which is tissue necrosis and occurs in limited areas with poor circulation.

What foot problems are most common in people with diabetes?

The following pictures depict the most common foot problems that can occur in any person. However, patients with diabetes have an increased risk of developing severe complications, including infection and even amputation.

A fungal infection of the foot is called athlete's foot. This disease causes cracked skin, itching and redness.

The fungus gets into cracks in the skin, causing an infection that needs to be treated. antifungal drugs. Oral medicines or topical creams can also be used to treat athlete's foot.

Thick, brittle, yellow-brown or opaque nails - common symptom fungal infection. The infected part may break off from the rest of the nail. The fungus loves the warm, moist, dark environment created by wearing closed shoes.

Damage to your nails also increases your risk of developing a fungal infection. Such infections are difficult to treat, but not impossible. Oral medications work well to treat fungal nail infections. Local treatment effective only against certain types of fungal infections. Sometimes surgery is necessary to remove infected areas of the nail.

Corns

Corns are areas of thickened skin that grow on the sole of the foot. The formation of corns can be caused by uneven weight distribution, skin pathologies or unsuitable shoes.

Rub the affected area with a pumice stone after a shower or bath. Ask your doctor to explain the best way to do this.
Use soft insoles in your shoes.
Ask your doctor to prescribe medications to soothe the corns.

Having a few corns is not that bad. It is important to never try to cut them off as this can cause serious injury.

A callus is a thickened area of skin that forms between the toes or near the bony prominences of the toes. Calluses can cause pressure and friction.

Use the following tips to care for calluses:

After a bath or shower, scrub the affected area with a pumice stone. Before doing this, consult your doctor.
Do not use callus removal products on your own.
Never try to cut calluses with sharp objects. This could result in serious injury.

Blisters are raised, fluid-filled areas of skin that form due to friction. Crushing or punching a blister is not the best way to treat it, since the skin covering the blister protects against infection.

To care for a blister, keep your skin clean, apply an antibacterial cream or ointment, and cover it with a bandage to reduce the risk of infection.

Hallux valgus deformity of the first toe

Hallux valgus Hallux valgus is a painful, red, calloused area that forms on the outside of the joint. thumb legs. This pathology can be observed on both feet and has a hereditary tendency to develop. Wearing uncomfortable shoes wearing high heels increases the risk of developing hallux valgus by squeezing thumbs in an unnatural position.

Covering the deformation with a special pad helps protect it. To hold the thumb in correct position Special finger separators and other devices may be used. If hallux valgus is very painful or disfiguring, surgery may be used to relieve symptoms.

Dry skin

Dry, cracked skin allows bacteria and other pathogens to enter your body, potentially causing an infection. Moisturizing soaps, lotions, and other products can help keep the skin barrier soft, intact, and healthy.

Leg ulcers

Leg ulcers are dangerous sores that can occur in patients with diabetes. When a small scratch, skin break or wound on the foot becomes infected, an ulcer can form.

In people with diabetes, wounds heal very slowly or not at all. Early diagnosis and treatment are necessary to reduce the risk of complications. Your doctor - best source information on how to properly care for foot wounds.

Hammertoe deformity

Weakening the muscles of the toes contributes to the development of hammertoe deformities. This weakening shortens the tendons in the fingers, causing them to bend.

Hammer toes can be hereditary. In addition, this pathology can be caused by wearing unsuitable shoes. Toe deformities can cause problems such as corns, sores, blisters and difficulty walking. Corrective shoes and splints can help treat and correct hammertoes. Sometimes surgery is necessary to straighten the affected fingers.

Ingrown nail

They got their name from growing into the skin along the edges of the nail plate. An ingrown toenail can cause pain and damage to the skin, which can lead to infection.

Wearing ill-fitting shoes increases the risk of developing an ingrown toenail. Intense exercise such as running and aerobics may contribute to this problem. Walking, squeezing your toes, and improperly trimming your nails can also cause this condition.

The best way to prevent ingrown toenails is to keep them trimmed. If an ingrown toenail becomes infected, professional treatment is necessary. medical treatment. Sometimes surgery is needed to remove the affected part of the nail and the growth zone from which it grows.

Plantar warts

Thickened areas on the sole of the foot that have small black spots or pores are most likely plantar warts.

They are caused by a virus. The affected areas of the skin are painful and may appear alone or in groups. Treating plantar warts on your own is a bad idea. When in doubt, your doctor can determine whether the lesion is a corn or a wart.

Taking good care of your feet can prevent problems from developing before they start! Follow these tips to reduce your risk of developing common problems with legs and serious complications associated with them.

Diabetes and foot problems

Living with diabetes requires you to pay special attention to your health and illness. Follow your doctor's instructions about diet, exercise, and medications.

Keeping your blood glucose levels within the recommended range is the best thing you can do to control your condition and protect your legs.

Diabetes mellitus and leg problems. Prevention tip No. 2

Carefully inspect your feet for redness, blisters, sores, calluses, and other signs of irritation. Daily checks are especially important if you have poor circulation.

Follow these tips for proper foot care:

Wash your feet daily with non-irritating soap and warm water.
Avoid getting your feet wet.
Dry your feet completely after swimming, paying special attention to the areas between the toes.
Do not apply lotion in areas between your fingers.
Ask your doctor which type of lotion is right for your skin.

Diabetes mellitus and leg problems. Prevention tip No. 4

After bathing, use a pumice stone or a special device to smooth out thickened areas of skin on your feet (corns and calluses).

It is best to rub them in one direction. Talk to your doctor about the right way using pumice stones or foot trowels.

Diabetes mellitus and leg problems. Prevention tip No. 5

Follow these care tips to prevent the development of ingrown toenails:

Once a week, carefully examine your toenails.
Trim your toenails straight using nail scissors.
Do not round your nails or trim their sides
Round the edge of the nail using a nail file after trimming.
Talk to your doctor about how to properly care for your toenails.

Diabetes mellitus and leg problems. Preventative advice №6

Proper shoes, socks and stockings can help protect your feet. Follow these tips:

Buy matching socks and stockings that have soft elastic.
Wear socks in bed if your feet are cold.
Do not wear sandals or walk barefoot, even if you are at home.
Wear well-fitting shoes.

Diabetes mellitus and leg problems. Prevention tip No. 7

If possible, raise your legs up when sitting.
Wiggle your toes frequently.
Take frequent breaks to stretch your fingers; move your foot in both directions.
Do not cross your legs, especially for a long time.

Diabetes mellitus and leg problems. Prevention tip No. 8

Quit smoking if you have this bad habit. Smoking worsens circulatory problems.

Diabetes mellitus and leg problems. Prevention tip No. 9

People with diabetes should visit a doctor (preferably a podiatrist) every 2-3 months, even if they do not have any problems with their legs. At each appointment, ask your doctor to carefully examine your feet. An annual foot examination should include:

Examine the top and bottom of the foot and the areas between the toes.
Study of inflammation and redness of the skin.
Assessment of foot pulse and temperature.
Assessing sensation in the leg.

When should you see a doctor?

Contact your doctor if you notice any of the following signs:

Changes in skin color or temperature.
Swelling of the foot or ankle.
The appearance of calluses, corns, ingrown nails, infected nails, dry and cracked skin.
Leg pain.
Unpleasant, persistent or unusual foot odor.
Ingrown toenails or nails infected with fungus.
Wet, open wounds with discharge that heals slowly.

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Disorders of carbohydrate metabolism are accompanied by an increase in blood glucose levels; the condition leads to damage to the innervation of the tissues of the lower extremities. The patient loses sensation and experiences constant pain in the legs. Therefore, in order to maintain the ability to move, it is necessary to begin treatment of legs with diabetes mellitus at an early stage of the disease.

Causes of damage to the lower extremities

High levels of sugar in the body contribute to impaired blood circulation in the vessels, affecting the transmission of impulses to nerve fibers, which leads to low sensitivity of the lower extremities. As a rule, damage to the leg occurs in an area that receives heavy load during movement.

Very often the condition is complicated by trophic ulcers and cracks, the reason for this is the patient’s untimely seeking of medical help.

The main causes of diseases of the lower extremities in diabetes mellitus:

decreased sensitivity;
blockage of blood vessels;
insufficient oxygen supply to tissues;
change in muscle trophism.

With severe hyperglycemia, patients often complain that their legs hurt due to diabetes. A feeling of pain in the lower extremities appears in both the first and second types of diabetes.

Typical reasons why legs hurt in diabetes:

Obesity. The second type of diabetes always occurs with excess body weight, and this puts additional stress on muscles and joints.
Age. Hyperglycemia enhances degenerative changes in bone and muscle tissue of the extremities.
Disorders of the cardiovascular system. Promotes poor blood circulation in the vessels and tissues of the legs.
Physical inactivity. Low physical activity leads to stagnation in lower parts torso.

Signs to start treatment for leg lesions

Leg disease most often occurs with type 2 diabetes, as it develops in older people against the background of atherosclerosis and obesity. Diabetics need to monitor the condition of their feet, conducting a daily inspection from toes to toes. femur, paying attention to areas exposed to increased load when walking. At the first symptoms of a change in the appearance of the lower extremities, immediate treatment should be started, since amputation of a limb is a serious complication of impaired blood circulation over a long period of time.

The patient should pay attention to the following signs:

dry skin and severe itching;
pigmented areas appear on the skin;
hair loss;
constant pale skin;
sore legs after minor exertion;
decreased sensitivity;
the appearance of edema;
the damaged limb is bluish in color;
long healing process wound surface;
numbness with tingling.

Most often, patients complain that their legs go numb after or during walking; the condition is accompanied by severe pain and often ends in cramps.

Main goals of diabetic foot treatment

How to treat legs with diabetes while maintaining the ability to move?

The main goal of diabetes therapy is constant control of blood glucose levels.

The choice of drugs for the treatment of symptoms of lower extremity lesions should be made on an individual basis, taking into account the patient’s compatibility with the drug.

Main directions of therapy:

relief or complete elimination of pain;
maintaining the ability to move;
restoration of blood circulation;
prevention of the development of atherosclerosis.

In the case when treatment is carried out at an early stage of the disease, it is first necessary to correct the lifestyle, establish a nutritious diet, reduce body weight, and perform moderate physical activity.

In case of severe disruption of blood flow, surgical intervention is indicated to restore its normal circulation.

Principles of treatment

Treatment of wounds on the legs should take into account the severity of the pathological process and the presence concomitant diseases.

Only after a comprehensive diagnosis can a specialist prescribe a drug that will be suitable for this type of pathology

Leg ulcers in diabetes mellitus are treated with antiseptic water and alcohol solutions in the area of immediate localization of the wound surface. To enhance the healing process of ulcers, wound healing agents are used, which promotes increased cell division and the formation of new skin cells.

With strong dystrophic changes skin must resort to surgical intervention, during which affected areas with signs of necrosis are eliminated.

The following groups of drugs are used in conservative treatment:

Reducing blood glucose levels (Rosiglitazone, Gliquidone, Liraglutide).
Reducing cholesterol levels (Zocor, Allicor).
Vasodilators (Verapamil, Cilostazol).
Antibiotics upon joining bacterial microflora(Amoxicillin, Rifampicin, Erythromycin).
Antiseptics (iodine, brilliant green, ethyl alcohol, hydrogen peroxide).
Painkillers (Ibuprofen, Voltaren, Indomethacin).

Treatment for leg swelling due to diabetes is aimed at reducing tissue swelling and preventing the progression of the condition. For these purposes, types of diuretics are prescribed that remove excess fluid from the body. Diuretics are prescribed provided there is no severe kidney damage.

Pain relief

Treatment for leg pain due to diabetes is aimed at reducing the level of hyperglycemia and eliminating painful sensations.

What to do at home to reduce pain without taking medications:

Selection of orthopedic shoes. By taking into account the anatomical features of the foot, the load on soft tissues is reduced, preventing the appearance of ulcers and cracks.
Normalization of body weight. Losing extra pounds will help improve tissue tolerance to insulin and reduce stress on your legs.
Gymnastic exercises. Special therapeutic exercises improve microcirculation of lymph in the tissues of the whole body.
Liquidation accompanying pathologies. By eliminating diseases of the cardiovascular system, you can reduce pain.
Physiotherapy. After a course of foot hydromassage using magnets on active points, pain and fatigue in the joints and muscles of the lower extremities are reduced.

ethnoscience

Most diabetics have a question about whether the symptoms of the disease can be cured by using alternative medicine recipes.

The disease can be cured by supplementing drug therapy folk remedies based herbal decoctions and infusions.

Treatment of legs with folk remedies for diabetes will help complement drug therapy

Effective recipes for relieving pain and swelling of leg tissues due to illness:

A decoction based on flax seeds. To prepare you need to take 2 tbsp. l. flax seeds, pour 500 ml of boiling water over them, cook for 15-20 minutes over low heat. Let the broth brew at room temperature for 2 hours, then filter. The decoction is consumed for 5 days, 2 times a day, 1/4 cup.
Alcohol tincture of Kalanchoe leaves. Chop the leaves of the plant thoroughly and place in a 500 ml saucepan. Pour vodka over Kalanchoe leaves or ethyl alcohol, leave to infuse for 2 weeks. Use as a lotion or for rubbing.
Cream based on nettle root and vegetable oil. Bring 150 ml of any oil to a boil, then add chopped nettle root to it and boil for 15 minutes. The cream is cooled and then applied to the swollen areas.

With timely detection and treatment of pathology, severe complications that can lead to leg amputation can be avoided. If you follow all the recommendations and prescriptions of a specialist, it is possible to maintain free movement without pain on both legs.

Persistent increases in blood sugar (glucose) levels can be associated with serious complications in people with diabetes.

Feet are particularly at risk. For people with diabetes, two complications called diabetic neuropathy and peripheral vascular disease can cause damage to the foot (and other parts of the body).

What is diabetic neuropathy?

Chronically elevated sugar levels associated with uncontrolled diabetes can cause nerve damage, which interferes with the ability to sense pain and temperature. This so-called “sensory diabetic neuropathy” increases the risk that a person with diabetes may not notice problems developing in his or her foot.

What is peripheral vascular disease?

What foot problems are most common in people with diabetes?

Athlete's foot

A fungal infection of the foot is called athlete's foot. This disease causes cracked skin, itching and redness.

The fungus gets into cracks in the skin, causing an infection that must be treated with antifungal medications. Oral medications or topical creams can also be used to treat athlete's foot.

Fungal nail infection

Thick, brittle, yellow-brown or opaque nails are a common symptom of fungal infection. The infected part may break off from the rest of the nail. The fungus loves the warm, moist, dark environment created by wearing closed shoes.

Damage to your nails also increases your risk of developing a fungal infection. Such infections are difficult to treat, but not impossible. Oral medications work well to treat fungal nail infections. Topical treatment is effective only for certain types of fungal infections. Sometimes surgery is necessary to remove infected areas of the nail.

Corns

Corns are areas of thickened skin that grow on the sole of the foot. The formation of corns can be caused by uneven weight distribution, skin pathologies or unsuitable shoes.

Rub the affected area with a pumice stone after a shower or bath. Ask your doctor to explain the best way to do this.
Use soft insoles in your shoes.
Ask your doctor to prescribe medications to soothe the corns.

Having a few corns is not that bad. It is important to never try to cut them off as this can cause serious injury.

A callus is a thickened area of skin that forms between the toes or near the bony prominences of the toes. Calluses can cause pressure and friction.

Use the following tips to care for calluses:

After a bath or shower, scrub the affected area with a pumice stone. Before doing this, consult your doctor.
Do not use callus removal products on your own.
Never try to cut calluses with sharp objects. This could result in serious injury.

To care for a blister, keep your skin clean, apply an antibacterial cream or ointment, and cover it with a bandage to reduce the risk of infection.

Hallux valgus deformity of the first toe

Hallux valgus is a painful, red, calloused area that forms on the outside of the big toe joint. This pathology can be observed on both feet and has a hereditary tendency to develop. Wearing uncomfortable high-heeled shoes increases the risk of developing hallux valgus by squeezing the big toes in an unnatural position.

Covering the deformation with a special pad helps protect it. Toe separators and other devices may be used to keep the thumb in the correct position. If hallux valgus is very painful or disfiguring, surgery may be used to relieve symptoms.

Dry skin

Leg ulcers

Leg ulcers are dangerous sores that can occur in patients with diabetes. When a small scratch, skin break or wound on the foot becomes infected, an ulcer can form.

In people with diabetes, wounds heal very slowly or not at all. Early diagnosis and treatment are necessary to reduce the risk of complications. Your doctor is the best source of information about how to properly care for foot wounds.

Hammertoe deformity

Weakening the muscles of the toes contributes to the development of hammertoe deformities. This weakening shortens the tendons in the fingers, causing them to bend.

Ingrown nail

Ingrown toenails get their name from when they grow into the skin along the edges of the nail plate. An ingrown toenail can cause pain and damage to the skin, which can lead to infection.

The best way to prevent ingrown toenails is to keep them trimmed. If an ingrown toenail becomes infected, professional medical treatment is necessary. Sometimes surgery is needed to remove the affected part of the nail and the growth zone from which it grows.

Plantar warts

Thickened areas on the sole of the foot that have small black spots or pores are most likely plantar warts.

Taking good care of your feet can prevent problems from developing before they start! Follow these tips to reduce your risk of developing frequent foot problems and serious complications associated with them.

Diabetes and foot problems

Living with diabetes requires you to pay special attention to your health and illness. Follow your doctor's instructions about diet, exercise, and medications.

Keeping your blood glucose levels within the recommended range is the best thing you can do to control your condition and protect your legs.

Carefully inspect your feet for redness, blisters, sores, calluses, and other signs of irritation. Daily checks are especially important if you have poor circulation.

Follow these tips for proper foot care:

Wash your feet daily with non-irritating soap and warm water.
Avoid getting your feet wet.
Dry your feet completely after swimming, paying special attention to the areas between the toes.
Do not apply lotion in areas between your fingers.
Ask your doctor which type of lotion is right for your skin.

After bathing, use a pumice stone or a special device to smooth out thickened areas of skin on your feet (corns and calluses).

It is best to rub them in one direction. Talk to your doctor about the proper way to use pumice stones or foot rubs.

Follow these care tips to prevent the development of ingrown toenails:

Once a week, carefully examine your toenails.
Trim your toenails straight using nail scissors.
Do not round your nails or trim their sides
Round the edge of the nail using a nail file after trimming.
Talk to your doctor about how to properly care for your toenails.

Diabetes mellitus and leg problems. Prevention tip No. 6

Proper shoes, socks and stockings can help protect your feet. Follow these tips:

Buy matching socks and stockings that have soft elastic.
Wear socks in bed if your feet are cold.
Do not wear sandals or walk barefoot, even if you are at home.
Wear well-fitting shoes.

Diabetes mellitus and leg problems. Prevention tip No. 7

If possible, raise your legs up when sitting.
Wiggle your toes frequently.
Take frequent breaks to stretch your fingers; move your foot in both directions.
Do not cross your legs, especially for a long time.

Quit smoking if you have this bad habit. Smoking worsens circulatory problems.

Examine the top and bottom of the foot and the areas between the toes.
Study of inflammation and redness of the skin.
Assessment of foot pulse and temperature.
Assessing sensation in the leg.

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Foot prevention

To avoid such complications from diabetes, the patient should learn to independently check their feet every day for any signs of infection, wash their feet daily and apply an emollient cream to dry areas. To have good circulation blood, the patient must lead an active lifestyle, he must stop smoking, and he must remind the doctor to examine his legs at every visit to the patient. You can learn about proper and competent care from the article School diabetes mellitus.

The disease is very insidious and you never know what will suffer first. Another big problem is that many doctors blame everything on diabetes and do not understand that a person fights for every centimeter of his body. It is not uncommon for a situation where a surgeon tells a diabetic that in your case it is better to amputate. I heard so many phrases like this, and after the first one, I walked on my own feet for about five years.

Doctors recommend that a patient who suffers from type 2 diabetes go for a check-up every three months. From time to time it is necessary full examination. This means measurement blood pressure, foot examination, neurological examination, ophthalmological examination. Blood glucose levels should also be measured regularly.

Long-term complications are: diabetic retinopathy (damage to the blood vessels of the eyeball), diabetic polyneuropathy(damage to the peripheral areas of the nervous system), diabetic nephropathy (kidney damage), atherosclerosis, as well as ischemic disease hearts.

People with diabetes should call their doctor if they experience headache, confusion, trembling, double vision, or dizziness. Calling a doctor is necessary, as these manifestations can transform into convulsions, loss of consciousness or hypoglycemic coma.

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Causes

With diabetes mellitus, especially if the second type, atherosclerosis develops. And what? older age, the more severe the narrowing of blood vessels. In case of stenosis, it is not delivered to the lower extremities sufficient quantity oxygen and nutrients, therefore pain occurs, which proportionally depends on the size of the lumen of the vessels. It is important to perform stenting in case of stenosis of 50%. This will not only help get rid of pain, but will also allow the vessel to maintain the necessary lumen for many years.

There are two courses of development of complications.

Damage to the nerves of the legs due to constant high sugar. As a result, it is impossible to conduct a nerve impulse, which leads to loss of sensitivity, so nothing may hurt, but the process still progresses. This disease is called neuropathy.
Progressive atherosclerosis, clogging blood vessels, contributes to the development of oxygen starvation. With this outcome, the pain syndrome is very pronounced. My legs hurt almost constantly.

The first course is dangerous because even the slightest microtrauma will go unnoticed, and weak immunity will lead to the development of an ulcer, the treatment of which will take a very long time.

Edema of the lower extremities

Edema is a symptom of nephrotic syndrome and atherosclerosis. The syndrome disrupts metabolic processes in the body, and sclerosis impedes blood flow. Therefore, if your legs hurt and swell, you should immediately consult a doctor, since diabetes mellitus in its decompensated form progresses very quickly. Especially if you have type 2 diabetes, in which patients monitor their sugar levels once a week.

In case of edema, it is important to carefully follow the diet, do special exercises, which will help alleviate the condition, and carry out the prescribed treatment, which will fight both the symptoms and the cause.

Ulcers of the lower extremities

Causes of ulcer formation in patients with diabetes:

disruption of tissue nutrition;
nerve conduction disorder
pathological processes in blood vessels;
mixed type.

Prerequisites include:

microcracks of the lower extremities;
burns;
corn;
injuries, damage.

Diabetic foot

The second most serious complication after a trophic ulcer. This disease is dangerous because it is detected in more than 80% of patients with diabetes mellitus who ignored the initial symptoms of the disease - swelling and pain. The result of severe and moderate cases is amputation. The level of amputation depends on the severity of the process and the depth of the lesion.

long experience of diabetes mellitus;
constant jumps in blood glucose concentration;
skin trauma.

Symptoms:

loss of sensation;
thickening of the skin;
pale skin;
swelling;
pain syndrome (legs hurt almost constantly, but the condition worsens during physical activity).

Treatment

Treatment of feet for diabetes mellitus has no standards. The approach to each patient is individual, which means that the treatment and recommendations will differ, since the severity of the disease and concomitant diseases are different for everyone.

There are three areas that are considered basic:

treatment of atherosclerosis;
elimination of diabetic foot syndrome;
surgery to restore blood flow.

Treatment of diabetic foot

If conservative treatment does not give positive results or it is no longer practical to carry it out, then a surgical method is used.

Conservative treatment:

diabetes compensation, that is, keeping glucose levels within normal limits;
antibiotics to prevent the development of bacterial inflammation;
the use of pain relief, mainly in the form of tablets;
prescribing medications that improve blood circulation and thin the blood;
the use of antiseptics in the form of ointments or patches.

Surgery:

necroectomy only if the area of necrosis is small;
plastic surgery of blood vessels or their removal if restoration of patency is impossible;
removal of fingers (a type of amputation);
leg amputation, the level depends on the degree of damage.

Treatment of ulcers

Unfortunately, patients seek help in the later stages and therefore about 80% of ulcers progress to inflammatory process, which does not respond to treatment for a long time. Just like the treatment of diabetic foot, the treatment of ulcers can be conservative or surgical.

Conservative is the most strict, so it is often carried out in a hospital under supervision medical personnel, because diabetes is not a disease that can be stabilized on its own.

Conservative:

maintaining sugar concentration within normal limits;
treatment of diseases of other organs and systems;
anesthesia;
unloading of the lower extremities;
drugs to restore nerves in the legs;
blood thinners;
use of antibiotics and antifungal drugs.

Surgery:

use of sterile bandages and dressings with preliminary antiseptic and antibacterial treatment;
necroectomy and cleaning tissue from pus;
vascular plasticity;
amputation (if all previous measures did not give the desired positive effect).

Complications

Complications of diabetes mellitus that result from the absence or improper treatment of the legs:

acute, recurrent inflammatory process caused by streptococci;
regional and then generalized inflammation of the lymph nodes and blood vessels;
sepsis, which is almost impossible to treat.

It is important to know that no treatment can replace a correct lifestyle. Even amputation of a limb is not the final stage if the patient does not comply with the doctor’s instructions. Another problem is that patients ignore the initial symptoms and come to the doctor with already advanced complications that require a radical solution.

On initial stages you can get by with self-massage, physical therapy which will improve blood circulation and relieve pain. However, if you have existing symptoms (such as swelling or numbness), it is important to discuss any exercise and massage with your doctor, as this can only complicate the course of diabetes. In the absence of any prerequisites, it is still worthwhile to engage in prevention; this will help not only improve the current condition, but also avoid serious problems in future.

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Severe vascular complications of diabetes mellitus

One of the most unpleasant consequences of this disease are complications of diabetes mellitus associated with the action high sugar blood into small vessels. For the patient, this means the risk of serious illnesses that greatly reduce the standard of living. That is why doctors insist that all patients maintain good compensation for diabetes, because this is the guarantee that complications will not develop.

Vascular complications of diabetes mellitus arise due to the fact that in patients, glucose from the blood quickly goes into the walls small vessels, they lose elasticity, become clogged, and as a result, the tissues around them stop receiving oxygen and nutrients from the blood and slowly die. Of course, the smaller the diameter of the vessels, the faster they will bleed. The smallest vessels are found in the eyes, kidneys, feet and pancreas. What complications of diabetes arise from poor diet? In this case, there is a decrease in vision up to blindness, impaired blood circulation in the legs up to gangrene and impaired kidney function up to renal failure and self-poisoning of the body.

What other complications can occur with diabetes? Secondarily, the brain, liver and pancreas are affected. As a result, it stops producing insulin, and diabetes requires, in the case of type II diabetes, a switch from tablets to insulin, or in the case of type I diabetes, a significant increase in insulin doses.

A drug has been developed that prevents changes in the structure of dendritic spines, as a result of which neurological pain decreases.

Having identified symptoms of diabetes complications, the doctor prescribes treatment.

Complications of diabetes mellitus on the legs: neuropathy and microangiopathy: photos and signs

Neuropathy and microangiopathy- these are microscopic changes that are one of the main complications of diabetes mellitus, and they can cause the patient big trouble. How to avoid this?

Here you can see photos of complications of diabetes mellitus on the legs - neuropathy and microangiopathy:

Microangiopathy in diabetes mellitus leads to the fact that the smallest wound or abrasion on the foot cannot heal on its own and threatens to turn into an ulcer. If more than large vessels, gangrene may develop, that is, necrosis of an area of the foot, most often one of the toes.

Nervous tissue is also capable of absorbing glucose from the blood; in addition, nerve trunks permeated with tiny vessels, which become empty with constant decompensation of diabetes mellitus. That's why nerve tissue no longer works as it should, and the diabetic’s sensitivity decreases. In this case, neuropathy occurs in diabetes mellitus, in which at first night pain like a burning sensation and “goosebumps crawl” are disturbing. Then numbness of the legs develops from the toes to the knee. Also signs of neuropathy in diabetes mellitus are a decrease in temperature and pain sensitivity, the so-called “socks” or “stockings”. Thus, even if an ulcer appears, a diabetic may not feel pain and, if he does not regularly examine his legs, may not be aware of the presence of an ulcer. Also, if a patient has neuropathy of the legs due to diabetes, he can get a serious burn unnoticed, for example, by placing a hot heating pad in bed.

The same changes occur on the hands. Therefore, a diabetic needs to be careful in the kitchen or when ironing clothes. He may not feel the burn and be seriously injured.

How to treat leg ulcers with diabetes and their photos

Look at the photo of what leg ulcers look like with diabetes and find out how to treat them:

If there are ulcers on the legs in diabetes mellitus, the affected limb must be unloaded. For this purpose, a special orthopedic shoes, cast or wheelchair. The ulcer is cleaned and ointment dressings are applied to it as prescribed by the podiatrist.

Your doctor or surgeon will tell you how to treat ulcers in diabetes mellitus. An endocrinologist helps achieve strict diabetes control, often through insulin therapy. Do not self-medicate under any circumstances!

Since an ulcer usually develops an infection, a course of antibiotics is given.

Vasodilators are used to restore blood circulation.

Strict compensation for diabetes is a prerequisite for recovery.

In case of gangrene, unfortunately, one has to resort to amputation.

After healing, you will likely need to wear orthopedic shoes.

Prevention of ulcers and gangrene of the lower extremities in diabetes mellitus

In case of such severe complications of diabetes as ulcers and gangrene, you should not:

hover your feet or put mustard plasters on your heels;
trim the corners of your nails;
use corn plasters;
cauterize wounds with alcohol or alcohol solutions of iodine and brilliant green (it is better to use hydrogen peroxide and syntomycin emulsion);
smoking (smoking significantly impairs blood circulation in the legs);
warm your feet by the fire or heating devices (if you want to warm the bed, take out the heating pad before you get under the covers);
cut off calluses independently or with the help of a callus operator (this should be done by a specially trained nurse in compliance with all antiseptic rules);
walk barefoot at home and on the street (you may not notice a small wound or cut);
wear shoes that are narrow, tight or rub (never buy shoes without trying them on. Try to choose shoes from genuine leather, with low heels or no heels at all, the toe should be wide enough. Do not use magnetic insoles);
wear socks or stockings with a tight elastic band (it is advisable to choose cotton socks. Patches and darning on socks are also dangerous).

To prevent gangrene of the lower extremities in diabetes mellitus, it is necessary:

inspect your shoes daily, check with your hand to see if there are small stones, folds, or studs inside;
wear new shoes no longer than one hour a day;
wash your feet daily warm water and dry them thoroughly (it’s best to put them in a bowl of warm water for a few minutes - this is a great way to relieve tension. You can add chamomile infusion to the water);
do foot exercises and massage daily;
lubricate your feet with cream every day, with the exception of the spaces between the toes;
trim nails horizontally without cutting corners (carefully handle sharp edges with a nail file);
check your feet daily. The foot can be examined by placing a mirror on the floor. Special attention you need to pay attention to the spaces between the toes, the tips of the fingers, the edge of the heel. This is where ulcers most often form. Consider whether excessively narrow shoes leave marks on your feet. If this is the case, your shoes should be changed. If vision is reduced, ask a relative to examine the legs;
warm cold feet with wool socks;
If you notice a small abrasion or abrasion or feel discomfort in your legs, you should consult a doctor. If a wound or ulcer appears, consult a doctor immediately.

Also, to prevent gangrene in diabetes mellitus, intramuscular courses of vitamins should be administered twice a year to treat neuropathy. Undergo physiotherapeutic treatment. If you have decreased sensation in your legs, notify your physiotherapist before starting sessions.

In case of circulatory problems, take courses of blood circulation-restoring drugs prescribed by your doctor. Some of these drugs are contraindicated for fresh hemorrhages in the fundus, so before using them, you must be examined by an ophthalmologist.

Maintain strict diabetes compensation.

Treat other diseases that contribute to the appearance of ulcers: atherosclerosis, varicose veins, flat feet.

If there are fungal diseases of the skin or nails, they must be treated by a dermatologist. To avoid fungal foot infections, never use someone else's shoes. In the pool or sauna, wear rubber slippers that cover the entire foot.

Regularly, once or twice a year, have your feet examined by an endocrinologist or, better yet, by a special doctor - a podiatrist.

Flat feet are not a consequence of diabetes, but they lead to the fact that shoes made for a normal foot become uncomfortable, abrasions occur, infection penetrates into them, and severe lesions occur. Therefore, a diabetic should be regularly examined by an orthopedist.

The bones of the foot are curved and form longitudinal and transverse arches, due to which the foot acts as a shock absorber. These arches are firmly tied together by ligaments and strengthened by muscles. Muscles back side the feet extend the toes, and the plantar muscles, which are much stronger, bend. With age or as a result of increased workload, for example during pregnancy, or increased weight, the ligaments weaken and the bones of the foot move apart. It becomes flat and is unable to function as a shock absorber.

If the ligaments are more loose anterior section feet, the bones of this section begin to shift relative to each other, as a result, the heaviest load begins to shift from the base of the big toe to the bases of the second and third toes, which are completely unsuited to this. At this point, a painful callus forms on the skin, which can turn into an ulcer in a diabetic. The plantar muscles begin to pull the big toe to the outer edge of the foot, it gradually displaces the second toe, and it rises up, creeping onto the big toe. Ulcers can also easily form in the interdigital space between the thumb and second toe with constant friction. On the inner edge of the foot at the base of the big toe, due to increased friction, a chronic inflammation joint, then a painful bone grows in this place. Similar changes can be found in perhaps every third person over 50 years of age.

Hypertensive retinopathy in diabetics

“Retina” translated from Latin means retina; “pathy” is pathology.

The surface of the eye by which we determine its color and on which the pupil is located is called the cornea. Directly behind the pupil is a small, clear lens. Next comes vitreous, the white part of the eye, and finally, in the very depths is the most important part of the eye - the retina. If we compare the eye with a camera, then the retina is a light-sensitive photographic film on which the image is printed. The endings are located here optic nerves and many tiny vessels that nourish the retina. It is with these vessels that misfortune occurs during decompensation of diabetes.

Hypertensive retinopathy - this is a complication of the eyes in diabetes mellitus, associated with changes in the retina over a long period of time arterial hypertension. With hypertension, pressure increases in all vessels. Naturally, the thin and delicate vessels of the fundus suffer from this more than large arteries and veins. In the fundus, the ophthalmologist can see changes in the diameter of blood vessels, and even minor hemorrhages; in the later stages, the optic nerve is affected.

The diagnosis of hypertensive retinopathy in diabetics is made after examination by an ophthalmologist, ophthalmoscopy and fluorescein angiography.

Treatment of retinopathy in diabetes mellitus includes normalization blood pressure with the help of drugs that improve blood circulation and nutrition of the retina.

For prevention hypertensive retinopathy the retina needs good compensation for diabetes mellitus and blood pressure control.

The symptoms of hypertensive retinopathy in diabetes mellitus are almost the same as those of diabetic retinopathy:

floating spots before the eyes;
the appearance of objects becomes blurry;
dark stripes or a red veil appear before the eyes, resulting in loss of vision;
with this complication of diabetes in the eyes, vision deteriorates at night;
sharp decrease in vision.

Diabetic retinopathy: symptoms and treatment

Here you will learn about the symptoms and treatment of diabetic retinopathy, a complication of diabetes in the eyes.

Even if the patient does not have any vision complaints, he needs to undergo preventive examination- ophthalmoscopy at least once a year. The first changes in the fundus are noticeable only to the ophthalmologist, and treatment must begin as early as possible. The doctor examines the retina in the fundus through an ophthalmoscope and makes a conclusion about the condition of its blood vessels. To clarify the diagnosis, fluorescein angiography (retinal blood flow study) is used, which reveals bloodless areas, newly formed vessels, and thrombosis of retinal vessels. Optical coherence tomography identifies retinal lesions at the cellular level.

The first symptoms of diabetic retinopathy are:

gradual decrease in vision, it is impossible to choose glasses in which the patient can see clearly;
the appearance of dark spots in the field of vision;
sharp decrease in vision.

At the first stage, the ophthalmologist sees only unevenly dilated vessels of the fundus. The most important treatment method at this stage is strict compensation of diabetes mellitus. As adjuncts to the treatment of diabetic retinopathy, doctors prescribe vasodilators, agents that prevent vascular thrombosis, antioxidant therapy, drugs that strengthen the vascular wall, and drugs containing microelements and vitamins necessary for the retina.

If compensation has not been achieved and the process continues, the blood vessels burst and the ophthalmologist sees hemorrhages. At this stage, doctors most often prescribe laser coagulation - cauterization of retinal vessels.

This procedure does not restore visual acuity, but protects against the development of further complications. If you don’t do it on time and continue to “torture” the fundus high sugars, grows at the site of hemorrhages scar tissue, which ultimately leads to blindness. This stage is called proliferative retinopathy, from the word “proliferation” - growth.

The best prevention of blindness due to diabetes is good diabetes control and regular eye exams.

Main complications of diabetes: cataracts

Like the walls of blood vessels, the lens is capable of absorbing glucose, which reduces its transparency and, consequently, visual acuity. Cataracts are common in older adults in healthy people, but they can develop earlier and more quickly in diabetics.

Symptoms of cataracts in diabetes are:

slow decrease in vision;
appearance of spots, blurred vision;
As a result of the disease, a person gradually but irreversibly loses vision, and it can result in complete blindness.

The diagnosis of cataracts in diabetes mellitus is made during an examination by an ophthalmologist. To treat this complication of diabetes, surgical removal of the lens is performed. The operation is simple and easily tolerated by patients.

Complication of diabetes mellitus glaucoma and its symptoms

Glaucoma is a serious disease of the organ of vision, which gets its name from the greenish color that the dilated and fixed pupil acquires when acute attack glaucoma. The same is the nature of the second name of this disease - “green cataract”.

Today glaucoma is commonly called chronic illness eyes, characterized by increased intraocular pressure.

Glaucoma can occur at any age, starting at birth, but the risks increase significantly in older age. If the percentage of congenital glaucoma is only one case per 10-20 thousand newborns, and after the age of 45, primary glaucoma is observed in approximately 0.1% of the population, then in people over 75 years of age it develops in more than 3% of cases.

Symptoms of glaucoma: temporary blurred vision, vision of rainbow circles around light sources, attacks of sharp headaches, after which a decrease in vision occurs.

The disease also often develops in old age. Glaucoma occurs more often and faster in diabetes; if the disease is not treated, it can lead to complete blindness.

Diagnosis of glaucoma in diabetes mellitus is carried out during an examination by an ophthalmologist with measurement of intraocular pressure. Treatment is prescribed medicinal or surgical.

To prevent glaucoma, you need good compensation for diabetes and examination by an ophthalmologist.

What is nephropathy in diabetes mellitus and its treatment

Below we describe what nephropathy in diabetes mellitus is and how to treat it.

The kidneys are known to filter the blood. The artery, entering the kidney, is divided into many small vessels. These vessels enter the renal glomeruli, where waste products and excess water are filtered from the blood, forming urine. If this process is disrupted, the body begins to poison itself. This is how one of the most dangerous complications diabetes mellitus on the kidneys - diabetic nephropathy.

“Nephro” from Greek means kidney, “pathia” means disease.

The cause of nephropathy in diabetes is the same changes in blood vessels: the wall of the smallest vessels becomes hard and porous, the filtration of urine from the blood is disrupted, gradually large protein molecules begin to fall into the formed pores, and, consequently, the usual protein composition blood. It is increasingly difficult for the heart to push blood through hard and thrombosed vessels, and in order for the kidneys to work at least somehow, the body increases blood pressure. However, this increase in pressure, like a hammer, drives glucose and cholesterol into the walls of blood vessels, speeds up blood flow and interferes with normal filtration. Thus, a vicious circle is closed. At the last stage it develops renal failure, that is, self-poisoning of the body.

The danger of this complication is that it develops quite slowly and does not cause discomfort in patients for a long time. The patient begins to feel unwell only in the last stages, when it is already difficult to help him. Therefore, even with feeling good You need to undergo regular examinations and receive appropriate preventive treatment.

Most early sign diabetic nephropathy - the appearance in the urine of the smallest protein molecules, microalbumin. At this stage, treatment is most effective. Therefore, every diabetic should do this test at least once a year.

At a later stage, the presence of protein in the urine is determined by routine tests. An increase in blood pressure and renal edema develops - first on the face, and then throughout the body. At this stage, treatment can still be quite effective if carried out consistently and systematically, and not occasionally.

To treat nephropathy in diabetes mellitus and prevent the disease, it is necessary:

Achieve good diabetes compensation. The closer the blood sugar level is to normal, the slower nephropathy develops.
Switch to insulin treatment.
Normalize blood pressure with drugs that improve blood circulation in the kidneys.
Adjust blood cholesterol levels through diet.
With the constant excretion of protein in the urine, it is necessary to limit the consumption of animal protein to 40 g per day, and it is better to generally replace animal protein with vegetable protein.

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Causes of development of leg diseases in diabetes

The main cause of pain in the legs is diabetes, which makes it possible to develop such a complication. The older a person with diabetes, the higher the risk of developing leg problems, which in the future cause a lot of trouble for both doctors and patients themselves.

Against the background of diabetes, atherosclerosis develops, which narrows blood vessels and they can't normal mode deliver blood to the lower extremities. As a result, the leg tissues do not receive the required amount of blood and oxygen and send pain signals that begin to greatly torment the diabetic patient.

If recovery surgery is performed in time correct flow blood flow in the arteries, this will help get rid of further development complications.

As diabetes progresses, leg pain can occur due to two scenarios:

The patient has chronically elevated blood sugar levels, which affects the nerve fibers of the lower extremities and they are no longer able to conduct impulses. This phenomenon is called diabetic neuropathy, which causes loss of sensitivity;
Developing atherosclerosis gradually clogs blood vessels and leads to the appearance of a blood clot and the development of ischemia ( oxygen starvation fabrics). In this scenario, the patient feels severe pain in the legs.

In the first scenario, when the patient has lost sensitivity and cannot feel pain, heat or cold, if he accidentally injures his leg, he does not pay attention to it, because doesn't feel anything. Small wound on the foot can lead to ulcers that long time don't heal.

Swelling of the legs due to diabetes

The manifestation of swelling of the lower extremities in diabetes may appear as a result of nephrotic syndrome, against the background of which regular swelling begins. Atherosclerosis, which clogs the walls of blood vessels and prevents normal blood circulation, can also be the impetus for swelling of the legs.

In this case, it is recommended that careful adherence to the diet, physical activity determined by the doctor, which will help stabilize the condition, and treatment aimed at ridding the patient of the cause of edema - atherosclerosis or nephrotic syndrome.

Foot ulcers in diabetics

Leg ulcers in diabetes mellitus develop for several reasons:

Against the background of tissue trophism (disturbance);
In case of innervation disturbance (neuropathic);
For vascular pathology (rheological);
Combined option.

In many cases, the active development of trophic ulcers against the background of diabetes mellitus is facilitated by:

atherosclerosis;
male gender;
severe vascular lesions;
damage to the peripheral nervous system.

The immediate precursors to the appearance of an ulcer are:

cracks and abrasions on the legs;
domestic burns;
calluses;
microtraumas and bruises.

Signs of ulcers and stages of their development

A diabetic patient must carefully and closely monitor not only the level of sugar in the blood, but also the condition of the entire body and the upper skin. As we have already noted, complications noticed in time can be stopped at the very beginning and even bigger problems can be avoided.

In diabetes, an ulcer does not appear immediately, but as a result of long-standing complications in the body, which may appear after several years.

In this article you will learn more about skin diseases in diabetes http://pro-diabet.com/oslozhneniya/kozha-pri-saxarnom-diabete.html

Here is detailed information about gangrene of the lower extremities in diabetic patients.

Trophic ulcers, according to the stages of their development, can be divided:

1.Previous stage of ulcer manifestation:

the skin's sensitivity to pain, temperature changes, and pressure decreases;
initially mild pain, itching, burning, and cramps appear in the lower leg area;
swelling appears;
The color of the skin of the lower leg changes, dark areas of the skin appear, redness, in rare cases - cyanosis, the skin becomes thinner.

2. Expanded manifestations:

visible defects of skin destruction appear, a scab forms;
the ulcer begins to bleed bloody discharge, and due to infection entering the wound, fester occurs and the volume of the ulcer increases.

3. Progressive stage of ulcer:

trophic changes develop into an infected purulent ulcer;
the first signs of intoxication of the body appear (weakness, high fever, chills, etc.);
pain increases;
necrosis may extend even deeper into the tissue.

Treatment of ulcers in diabetes mellitus

Average statistical data from diabetologists indicate that more than 80% of patients with diabetes seek help with complications too late, when it is necessary to apply intensive treatment of ulcers, which does not always give the expected results.

All methods of treating ulcers can be divided into conservative, aimed at eliminating the cause of the ulcer, and surgical - radical method, used as primary or secondary.

The conservative method is used only with a doctor’s prescription and under his strict supervision; all contraindications and features of the course of diabetes mellitus are taken into account.

Program conservative treatment ulcers in diabetes mellitus:

Strict control of sugar and hemoglobin. The optimal possible level of glycemia is from 6 to 10 mmol/l (on an empty stomach), from 9 to 10 mmol/l after meals;
Treatment and prevention of possible concomitant diseases (thrombophlebotic diseases, high blood pressure);
Reduction of pain syndrome;
Application of unloading methods for the lower extremities;
The use of medications that help improve the condition of the peripheral nervous system;
Correction of blood clotting using drugs;
Improving lipid metabolism;
Use of vasoactive drugs;
Carrying out antifungal and antibacterial therapy.

Surgical program for the treatment of ulcers in diabetes mellitus:

Treating the surface of the wound with special preparations (peroxide), applying sterile dressings;
Carrying out an autopsy, removing pus while preserving the maximum possible tissue;
Carrying out surgery for vascular reconstruction (if there are prerequisites).

If the treatment does not produce the expected results, then the volume surgical treatment increases, even to the point of amputation of limbs.

Complications from ulcers in diabetes mellitus:

Like any other disease that develops against the background of diabetes, ulcers can provoke complications:
erysipelas;
inflammation lymph nodes and vessels;
a septic condition develops.

General treatment of legs for diabetes mellitus

Depending on the severity of the disease, they can be used for treatment three directions, developed by modern medicine:

Impact on certain factors that stimulate atherosclerosis;
Treatment of diabetic foot syndrome;
Resolving the issue of surgical intervention to restore blood flow in the tissues of the lower extremities.

After a trophic ulcer developing against the background of diabetes mellitus, the second serious illness, which occurs with diabetes, is diabetic foot, in which pathological changes occur on the patient’s foot. The result of neglect and lack of treatment is amputation of a limb at any level.

This complication occurs in 90% of diabetic patients who have not noticed initial signs development of the disease - pain in the legs, swelling.

Causes of diabetic foot syndrome

The development of a diabetic foot is a rather complex mechanism, which involves various processes of the body against the background of diabetes mellitus.

Long-term diabetes and regular surges in sugar levels lead to gradual destruction of blood vessels in all tissues of the body. It all starts with damage to small capillaries, and leads to global destruction of blood vessels, impaired circulation, death of nerve endings, failure of metabolic processes and skin damage.

In case of skin trauma healthy person, the healing process occurs quite quickly, but in diabetes, when the movement of blood through the vessels is completely disrupted, minor injuries lead to serious consequences - ulcers, diabetic foot, purulent processes are added.

Signs of diabetic foot

Symptoms of the disease may differ slightly depending on what form of the disease is already present:

The neuropathic form provokes severe damage to nerve endings. The lower limbs lose their sensitivity, the pain threshold increases, the shape of the foot changes, and the skin thickens.
The ischemic form is characterized by vascular damage. The skin on the foot turns pale, swelling appears; there is pain, the foot is not deformed, there are no calluses.
Mixed, the most common form diseases.

Treatment of diabetic foot

Today there are two methods of treating this disease - conservative and surgical.

Conservative treatment method:

Normalizing sugar levels;
The use of broad-spectrum antibiotics (prescription is individualized depending on the type of ulcer);
Prescribing pain medications;
Improving blood flow through the vessels;
Use of local antibacterial and antiseptic drugs (individually).

Surgical treatment of diabetic foot:

A small area of necrosis is removed;
Restoration of the condition of blood vessels (angioplasty);
Removal of those vessels that could not restore their condition and function (endarterectomy);
Installation of meshes on the vessels that will support them (arterial stenting);
Resection of an area of gangrene (removal of a fragment of a finger or foot);
Amputation of the foot, ankle, leg, depending on the need.

All developed programs and methods for treating leg pain will be ineffective if a patient with diabetes mellitus does not take independent steps to alleviate his condition.

Many doctors say that if all those suffering from diabetes noticed the beginning complications in time, many problems could be avoided with little blood.

For example, when a patient begins to feel even slight numbness in the lower extremities, increased leg fatigue and swelling, he should immediately consult a doctor and use home therapy, which consists of foot massage, active image life and exercise therapy. These methods will help restore blood circulation, improve the condition of blood vessels and get rid of pain.

Before you start moderate physical activity and use massage, you should consult a doctor who will develop individual program treatment, according to the characteristics of diabetes mellitus and the properties of your body.

And even if a patient with diabetes mellitus does not see any signs of complications, does not feel pain in the legs, there is no need to relax - carry out preventive measures, preventing the development of leg problems.

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Diabetic angiopathy of the lower extremities

One of the reasons why legs hurt in patients with diabetes is diabetic angiopathy. It develops as a result of damage to small (microangiopathy) and large (macroangiopathy) blood vessels. The complication occurs against the background of incorrectly selected treatment or its absence. High performance blood glucose levels, as well as sudden and repeated changes during the day, have a destructive effect on capillaries and large arteries.

As a result, glucose begins to intensively seep into the thickness of the walls of the blood vessels of the legs. It disrupts their structure and reduces permeability. The pathological process is accompanied by the accumulation in the walls of blood vessels of glucose metabolic products (fructose and sorbitol), which have the ability to accumulate fluid. The vascular walls filled with moisture swell, swell and thicken. Their lumen narrows sharply.

High glucose levels activate the process of thrombus formation. Blood clots forming on the walls of blood vessels further narrow the lumen and impair blood circulation.

Endothelium destroyed by glucose (layer of cells lining inner surface vessels) loses the ability to produce a substance that regulates the width of blood vessels. Their narrowing can be so strong that blood circulation in the capillaries can completely stop. Blood vessels are more likely to break down in the lower extremities, which is why people with diabetes have leg pain.

Vasoconstriction is promoted by the atherosclerotic process, which occurs due to lipid metabolism disorders. Cholesterol deposits formed on their walls increase due to the proliferation of connective tissue. Due to a critical deterioration in blood circulation, tissues suffer from hypoxia (acute lack of oxygen).

For diabetic angiopathy Characterized by the appearance of a feeling of numbness, coldness and “running goosebumps” in the legs. With severe narrowing of the lumen of blood vessels in the lower extremities, cramps and pain appear.

Pain in the legs in diabetes is so severe that it causes a person to limp. Pain syndrome usually occurs during movement, when tissues need additional portions of oxygen.

Diabetic neuropathy

Legs hurt in diabetes when diabetic neuropathy develops. The complication is characterized by damage to the nervous system. Nervous system consists of nerve fibers collected in bundles, which are held together by a sheath of connective tissue (perineurium). The perineurium contains blood vessels that supply nerve fibers.

In diabetes mellitus, sharp fluctuations in blood sugar concentration are observed:

High levels of glucose in the bloodstream cause fructose and sorbitol to accumulate in nerve fibers, causing swelling. As a result, the nerve bundles partially lose their functions. Along with diabetic changes, the myelin sheaths that insulate the nerve fibers are destroyed. Because of this nerve impulses scatter and do not reach ultimate goal. Over time, the fibers atrophy and stop transmitting nerve signals. If diabetes mellitus is accompanied by high blood pressure, nerve cells may die as a result of spasm of small capillaries.

Leg pain in diabetes mellitus occurs in response to any minor skin irritation. Sometimes the patient may wake up at night from the pain caused by the touch of the blanket. Damage to nerve fibers usually occurs symmetrically on both lower extremities. Unpleasant sensations appear on the skin in the form of tingling, burning, and “goosebumps.”

Sometimes a sharp dagger pain pierces the legs. They reduce sensitivity. This condition is called sock syndrome. A person feels objects touched by his foot indistinctly, as if he were wearing socks. His lower limbs are constantly cold. Due to decreased sensitivity in the legs, the patient's coordination of movements is impaired. The lower limbs do not obey him. Restriction of movement and poor circulation cause muscle atrophy. They lose strength and decrease in size.

Decreased sensitivity does not allow a person to feel pain in the legs when injured, or to feel a sharp or hot object. He may not notice an ulcer on his leg for a long time. This condition is dangerous to the patient's health.

Diabetic arthropathy

Diabetic arthropathy develops against the background of neuropathy. Because of decreased sensitivity a person's legs are often injured. But bruises, sprains, micro-tears of ligaments and muscle fibers go unnoticed by them.

Due to lack of treatment, foci of inflammation occur in injured tissues. Affected predominantly small joints stop. Pathological processes cause an increase in blood flow in bone tissue. Its consequence is the leaching of minerals from the bones. The pathology also progresses due to deterioration of nutrition cartilage tissue joints, which occurs against the background of a decrease in the lumen of blood vessels.

Such leg diseases develop less frequently in type 2 diabetes than in type 1 diabetes. Features of the disease:

On initial stage The disease causes swelling of the extremities in the joint area. The skin in this area turns red and becomes hot. Slight pain may be observed if the pathological process has not caused serious damage to the nerve fibers. With diabetic arthropathy, foot deformity is clearly visible. The patient suffers from frequent dislocations and fractures of the leg bones. Diabetic changes usually appear in both legs with little time difference.

Inflammatory processes are often complicated by the addition of a secondary infection, which provokes phlegmon and abscesses.

Diseases of the skin of the feet in diabetes mellitus

Metabolic disorders cause the development dermatological diseases. Patients often develop brown spots on their legs due to diabetes. They are a sign of diabetic dermopathy. Round or oval lesions are covered with small flaky scales and do not cause discomfort to a person. For dermopathy, no treatment is prescribed.

Due to a violation of carbohydrate metabolism, spots with a coating may appear on the skin of the legs, the color of which varies from yellow to red or bluish. This disease is called necrobiosis lipoidica. Skin covering becomes very thin and vulnerable. As the disease progresses, painful sores may develop. Over time, they disappear on their own. A brownish stain remains in their place. Necrobiosis lipoidica is found mainly in patients with type 1 diabetes mellitus.

Peeling skin on the legs is a sign of diabetic atherosclerosis. They are covered with painful and difficult to heal wounds. Diabetic atherosclerosis can cause painful sensations in the leg muscles.

Diabetic blisters are subcutaneous nodules. They resemble a regular burn. The disease goes away on its own without treatment after a few weeks.

With diabetes mellitus, yellow formations (plaques) may appear on the skin of the legs. They are a sign of xanthamatosis. Xanthomas can reach 2–3 cm in diameter. They appear as a result of lipid metabolism disorders and are lipid deposits.

Darkening of the skin around the joints of the legs may indicate acanthosis nigricans. It develops in patients with type 2 diabetes mellitus against the background of increased insulin resistance. In the affected areas, the skin thickens, itches and emits an unpleasant odor.

Treatment of complications of diabetes mellitus

If signs of diabetes complications appear, you should consult a doctor. He will diagnose the disease, determine the stage of its development and tell you what to do in this case. If necessary, treatment will be prescribed.

Therapy is aimed at lowering blood sugar levels and preventing sudden spikes. Patients are prescribed meglitinides (Nateglinide, Repaglinide) or sulfonylurea derivatives (Gliclazide, Liquidon, Glimepiride).

Treatment of legs for type 2 diabetes mellitus is carried out with the help of drugs that increase tissue sensitivity to insulin. These include thiazolidinediones (Rosiglitazone, Ciglitazone, Troglitazone, Englitazone). To reduce the absorption of carbohydrates in the intestine, alpha-glucosidase inhibitors (Acarbose, Miglitol) are used.

To reduce pain, non-steroidal anti-inflammatory drugs (Nimesulide, Indamethacin) are prescribed. Local anesthetics are also used (Versatis with lidocaine, Ketoprofen gel). At severe pain Tricyclic antidepressants (Amitriptyline) are used. To eliminate painful convulsions, anticonvulsants (Gabalentin, Pregabalin) are prescribed.

Neurotropic drugs (Milgamma, vitamins B1, B6 and B12) help treat diabetic legs. They relieve inflammation, help restore nerve fibers and improve the conduction of nerve impulses.

Simvastatin, Lovastatin or Atorvastatin are used to lower cholesterol levels. Lowering blood pressure is achieved by taking Veralamil, Nifediline, Lisinopril. To strengthen blood vessels, the attending physician will prescribe Pentoxifylline, Bilobil or Rutoside. In addition, diuretics (Furosemide, Spironolactone) are indicated. To prevent blood clots, take Aspirin or Sulodexide.

To improve metabolic processes, injections of Solcoseryl or Trifosadenine are prescribed.

Sometimes, after treatment, the symptoms of leg diseases may worsen. This reaction indicates the restoration of nerve fibers. A decrease in pain and discomfort occurs after two months.

How to care for sore feet

People with diabetes need to examine their feet daily, including the toes and the areas between them. They must be washed regularly with warm water (not hotter than 37°C). After using the toilet, the skin should be carefully dried.

It is not allowed to warm your feet, walk barefoot or wear shoes without socks. Treatment of calluses and other skin diseases can only be carried out after consultation with a doctor and under his supervision.

Avoid wearing tight shoes with rough edges, inseams or unevenness. Socks with seams should not be used. They need to be changed daily. Nails should be cut with blunt-tipped scissors. In this case, you should not round the corners of the nail plate. If unusual sensations appear, the patient should consult a doctor.

Diabetes mellitus is one of the most formidable and dangerous diseases of the 21st century. Not so much hyperglycemia itself, but its consequences. The main danger that awaits most patients is complications of the disease.

They can manifest themselves in different ways, but the first bell is often a change in sensitivity in the lower extremities and the appearance of discomfort when walking.

Therefore, patients often look for an answer to the question of why their legs hurt with diabetes. In order to explain the formation of pathology, it is necessary to delve into the mechanism of metabolic disorders.

Causes of leg pain in diabetes

It’s worth saying right away that this symptom is not always specific to the “sweet disease”. Sometimes it indicates other disorders in the body.

The most common reasons why legs hurt in diabetes are:

Increased quantity serum glucose. There is a direct relationship between glycemic levels and unpleasant sensations in the lower extremities. The larger it is, the stronger the subjective manifestations and classic symptoms of the disease.
Obesity. (DM 2) is almost always accompanied overweight body that creates additional load on joints and muscles. This causes aggravation of discomfort.
Age. Every person gets old. Characteristic temporary changes affect the quality of his life and the condition of all organs and systems. Negative influence hyperglycemia only enhances pathological changes.
Cardiovascular problems. Macroangiopathy is a faithful companion of diabetes. Damage to the arteries and veins directly leads to disorders of the blood supply to the legs.
Sedentary image life. In addition to the pathology of carbohydrate metabolism, fluid stagnation develops in the pelvis and peripheral tissues. Developing.

How to get rid of pain due to diabetes?

What to do if your legs hurt with diabetes? This is the first question that patients ask doctors at their appointment. Can pills relieve an unpleasant symptom? Yes, sure.

The main thing that the patient must understand is that discomfort in the lower part of the body is caused by permanent and the number 1 remedy to prevent the progression of the problem is to reduce sugar levels.

There are a few first steps you need to take:

Be comprehensively examined for diabetes.
Establish the type, stage and degree of compensation of the pathology.
Immediately begin treatment of the disease. The longer you wait, the worse the result will be.

In addition to traditional insulin injections for the 1st version of the “sweet disease” or tablets for the 2nd, the following important aspects must be additionally monitored:

Selection of comfortable shoes. One of the fundamental principles of preventing the development of diabetic foot syndrome, in addition to normalizing serum glucose. There are special orthopedic sneakers and shoes that are tailored to the patient’s order, taking into account all the anatomical features of the person’s foot. Such a wardrobe element is sometimes expensive, so a good solution would be to buy spacious shoes that do not pinch. Constant compression of soft tissues in boots very soon leads to the formation of small wounds, and then ulcers.
Getting rid of extra pounds. Patients with concomitant obesity especially need to lose weight. This will not only reduce the stress on joints and muscles, but also increase the body's sensitivity to insulin.
If your legs hurt slightly due to diabetes, it is recommended to perform a lung test. Physiotherapy will lower blood sugar and improve microcirculation.
Parallel therapy of other diseases. The main direction is liquidation cardiovascular pathology, which directly increases discomfort in the lower extremities.
When the first signs of morphological changes in the skin appear, you must immediately see an endocrinologist and surgeon to prevent further progression of the disease.

ethnoscience

We must not forget about unconventional ways to improve the patient’s condition.

Contrast shower for feet. It is enough to pour the lower extremities once a day for 10 minutes hot water and 3 minutes cold. This effect will increase blood flow and improve microcirculation processes, which will have a beneficial effect on tissue health.
Using an aqua massager. Vibrating vibrations of water perfectly increase blood circulation in distant parts of the body. In addition, such an intervention perfectly relaxes and calms the patient.
Comfrey. To prepare an infusion from it, you need to take 1 tablespoon of the ground root of the plant and add a liter of alcohol or vodka. Leave for 21 days, strain and dilute to obtain 3 liters of drink. Take a tablespoon 3 times a day after meals.

To relieve inflammation and pain, it is recommended to use ointments based on non-steroidal anti-inflammatory drugs (Fastum-gel, Dicloberl and others). They are applied in a thin layer to the affected area. lower limb. However, one should not expect a miracle from their use, since the main problem is systemic hyperglycemia, and not local pathological processes.