As per the statistics of the American Diabetes Association, approximately 38.4 million Americans are suffering from diabetes. Among these, 29.7 million have been diagnosed while the rest are yet to be tested. Having a higher blood sugar level (BSL) than normal, these people are more prone to diabetic foot infection as bacteria spread faster when they get their energy-producing molecule in excess i.e. glucose.
In the worst-case scenario, the severity of diabetic foot infection could also lead to amputations. In this regard, according to the Centers for Disease Control and Prevention (CDC), every year, 130,000 diabetic foot patients are hospitalized for amputational procedures.
However, the good news is that these amputations can altogether be avoided by proper prevention as well as timely treatment of the infections, commonly present on the feet. Let us dive deeper into this discussion.
Diabetic Foot Infection: Signs and Symptoms
To diagnose diabetic foot infection based on its signs and symptoms, the given guidelines should be followed:
● The first thing to look for to diagnose a diabetic foot infection is to check the presence of blisters, ulcers, cuts, or abrasions.
● If a patient feels pain in the toe due to a sharp-edged toenail, it could also be a sign of diabetic foot.
● Apart from these, a draining wound that has a foul smell and yellowish-green color also indicates diabetic foot.
● In addition, redness and inflammation of the affected area could also mean that an infection is present.
● In most cases, the patient can also feel pain. However, people with significant neuropathy do not have any pain perception.
How to Prevent Diabetic Foot Infection?
For the prevention of diabetic foot infection, the following measures are recommended by the healthcare experts:
● Don’t Miss Your Medication
By the proper use of medications on a daily basis, the patients can effectively control their blood glucose levels. This way, the risk of getting an infection is significantly lowered.
● Keep Your Feet Clean
People with diabetes should make a habit of cleaning their feet on a daily basis. In addition, feet should also be inspected to rule out the possibility of any wound. Special focus should be given to the areas with callused skin. If a wound is noticed, proper care needs to be taken until complete recovery. For guidance, a patient should contact their healthcare expert.
● Wear Supportive Footwear
To help diabetic patients to prevent diabetic foot infection, special supportive footwear is available which includes good-fitting shoes with wide and deep toe boxes. Materials such as leather, canvas, and suede are good at preventing moisture buildup which, in turn, minimizes the chances of blisters and fungal infections.
● Regular BGL Monitoring
As a general rule, diabetic patients should regularly check their blood glucose levels and keep a record. If the BGL levels are consistently high, the patient should immediately make an appointment for a proper medical checkup as well as treatment planning.
How to Treat Diabetic Foot Infection?
If a wound has been diagnosed in a diabetic patient, proper wound care becomes necessary not only to speed up the recovery process but also to eliminate the chances of amputation. This care involves the following stages:
● Cleaning the Wound
The first and most essential task is the thorough cleaning of the wound for which normal saline (0.9% aqueous solution of sodium chloride) should be employed. All the debris of the damaged skin cells should be removed with care. A wound is healed when new healthy skin cells are formed which cover the damaged area. For this purpose, a moist environment is necessary which is also provided by the saline water. Generally, washing should be done once a day.
● Application of Topical Medications
Topical medications such as creams, gels, or antibiotic ointments prescribed by the physician should be applied once the wound has been washed and cleaned.
● Covering the Wound
After cleaning and application of medication, the wound should be covered using a clean gauze dressing. As scientific evidence has not suggested, the moist dressings do not have any superiority over the dry ones. Therefore, any dressing that is easily available should be utilized. In this regard, the following dressing types are suitable for diabetic foot ulcers:
– Alginate dressings
– Hydrocolloid-based dressings
– Hydrogels
– Iodine-based dressings
– Silver-impregnated dressings
– Low-adherence dressings
● Offloading the Pressure
To reduce the pressure on the wounded foot, the use of walkers, removable and non-removable casts, custom-fabricated shoes and insoles, and different kinds of orthotic devices should be used.
● Negative Pressure Wound Therapy
A comparatively newer method for the treatment of diabetic foot ulcers is the use of targeted negative pressure wound therapy. It is a technique that is employed to drain out all the fluid from the wound using a sealed vacuum. In some cases, this method has been proven helpful in speeding up the recovery process but further evidence of its efficacy is still required.
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Conclusion
Infections in diabetic patients are always hard to get rid of as the bacterial buildup is huge in the presence of glucose. Nevertheless, it is essential to prevent injuries, bruises, and cuts in diabetics. If a wound is already present, proper medical care can save the patient from an amputation. For this purpose, the measures summarized in this article should be adopted.
Moreover, after consulting a relevant healthcare provider, treatment guidelines should be set without delay, and topical as well as oral medications should be started immediately. After all, diabetic foot ulcers are, indeed, painful and hard to tackle but definitely not impossible to heal.
References
● https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5349377/
PhD Scholar (Pharmaceutics), MPhil (Pharmaceutics), Pharm D, B. Sc.
Uzma Zafar is a dedicated and highly motivated pharmaceutical professional currently pursuing her PhD in Pharmaceutics at the Punjab University College of Pharmacy, University of the Punjab. With a comprehensive academic and research background, Uzma has consistently excelled in her studies, securing first division throughout her educational journey.
Uzma’s passion for the pharmaceutical field is evident from her active engagement during her Doctor of Pharmacy (Pharm.D) program, where she not only mastered industrial techniques and clinical case studies but also delved into marketing strategies and management skills.
