Diabetischer Fuß

Abstract

These are the guidelines for preventive care, diagnosis and treatment of the diabetic foot syndrome. Diabetic periphery neuropathy, peripheral vascular disease, bone deformity and altered biomechanics are foot-related risk conditions. The position statement is focused on screening methods and recommendations for clinical care for diabetics, who currently have no foot ulcers. A decision pathway is offered with respect to diagnosis and management of diabetic patients at an increased risk or manifest injuries.

Diabetic Foot Care in Patients with Mental Illness

“…Early detection of diabetes leading to initiation of diet and exercise regimens with possible utilization of oral hypoglycemics has positive outcomes for patients. The signs and symptoms of diabetes include: (a) lethargy, (b) chronic feelings of hunger, (c) excessive urination with corresponding feelings of being thirsty most of the time, (d) dry skin, and (e) blurred vision [15]. Patients with diabetes are also prone to yeast infections due elevated blood sugars providing a nutritional source for yeasts and due to their immunocompromised status.…”

“…Nerve damage associated with neuropathy can cause long duration for injuries to heal while also causing numbness and tingling in extremities. It takes a combination of factors, such as the patient history, family history, clinical foot exam, and the utilization of diagnostic exams, to best screen the patient for severity of DFD [15].…”

“…A prominent risk factor, which leads to adverse effects from diabetes is the asymptomatic nature of this illness in its early stage. reflexes, and pedal edema on rating scales [15]. Commonly used screening diagnostic methods, such as neuropathy symptoms scores, Semmes-Weinstein monofilament, vibration perception on the lower extremities from distal to proximal, nerve conduction studies, and even nerve biopsy, are valid tools in the arsenal for diabetic neuropathy foot screenings [15].…”

“…The screening criteria for DFD must include initial awareness and identification that a patient is vulnerable for foot ulcerations due to the diagnosis of diabetes. The patient must be made aware that routine inspection of the foot on a daily basis (while in the shower for example) is essential to prevent damage to the foot, shedding light on the symptoms to look out for in DFD, such as temperature changes in the foot, tingling, and painful feet [15]. It is important that the patient wears protective shoes, which helps reduce stress on specific parts of the foot and reduces exposure of the foot to outside risk factors, leading to foot trauma and keeping an eye out for any calluses, hammertoes, or hardening of certain areas of the foot [15].…”

“…The patient must be made aware that routine inspection of the foot on a daily basis (while in the shower for example) is essential to prevent damage to the foot, shedding light on the symptoms to look out for in DFD, such as temperature changes in the foot, tingling, and painful feet [15]. It is important that the patient wears protective shoes, which helps reduce stress on specific parts of the foot and reduces exposure of the foot to outside risk factors, leading to foot trauma and keeping an eye out for any calluses, hammertoes, or hardening of certain areas of the foot [15]. There also needs to be regular follow-up by patients with their clinicians, depending on the nature of their DFD, which might range from a yearly foot examination to seeing a clinician every couple of months if there is already an ulceration present [15].…”