A Review Article on Diabetic Foot

Abstract

INTRODUCTION: Foot infections are the most common problems in patients with diabetes. These individuals are predisposed to foot infections because of a compromised vascular supply secondary to diabetes. Local trauma and/or pressure (often in association with lack of sensation because of neuropathy), in addition to microvascular disease, may result in various diabetic foot infections that run the spectrum from simple, superficial cellulitis to chronic osteomyelitis. Globally, diabetic foot infections are the most common skeletal and soft-tissue infections in patients with diabetes. The incidence of diabetic foot infections is similar to that of diabetes in various ethnic groups and most frequently affect elderly patients. There are no significant differences between the sexes. The mortality risk is highest in patients with chronic osteomyelitis and in those with acute necrotizing soft-tissue infections. PRECIPITATING CAUSES OF FOOT ULCERATION AND INFECTION:  Friction in ill-fitting or new shoes.  Untreated callus.  Self-treated callus.  Foot injuries (unnoticed trauma in shoes or when walking barefoot).  Burns (for example, excessively hot bath, hot water bottle, hot radiators, hot sand on holiday).  Corn plaster.  Paronychia.  Artefactual (self-inflicted foot lesions are rare; occasionally failure to heal is due to this cause).  Heel friction in patients confined to bed.  Foot deformities (callus, clawed toes, bunions, pes cavus, hallux rigidus, hammer toe, Charcot's foot, deformities from previous trauma or surgery, nail deformities, edema) NEUROPATHY: More than 60% of diabetic foot ulcers are the result of underlying neuropathy. 1,2 The development of neuropathy in affected patients has been shown in animal and in vitro models to be a result of hyperglycemia-induced metabolic abnormalities .3,4,5 One of the more commonly described mechanisms of action is the polyol pathway. 4 The hyperglycemic state leads to an increase in action of the enzymes aldose reductase and sorbitol dehydrogenase. This results in the conversion of intracellular glucose to sorbitol and fructose. The accumulation of these sugar products results in a decrease in the synthesis of nerve cell myoinositol, required for normal neuron conduction. Chemical conversion of glucose results in

Role of Silicea in Diabetic Foot Ulcer: A Retrospectively Analysed Case Series

“…Thorough and systematic evaluation and categorisation of foot ulcers help to guide appropriate treatment and can often prevent exacerbation of the problem and eliminate the potential for amputation. 2 destruction of the bones, periosteum and fibrous tissues in any part of the body. 6 Outside homoeopathy, Silicea as an internal remedy is practically unknown.…”