Diabetic foot ulcer

Diabetes mellitus (DM) has many complications. Diabetic foot ulcer and diabetic retinopathy are 2 of chronic diabetic complications.

Causes of diabetic foot ulcer

High level of blood glucose

Glucose facilitates infection because it provides a rich environment for microbes.

Vascular complications

This reduces the amount of blood supplying feet thus will make it difficult for any wound or infection to heal.

Damage to the peripheral nerves

This leads to loss of sensation in the feet so the patient wouldn’t feel pain when wounded or when his wound becomes infected.

Diabetic dry feet

The dry skin is easily cracked and wounded thus, any small wound in the foot won’t be noticed because of lack of sensations, and then will not heal and will be infected too.

The infected wound will get deeper and wider to form an ulcer secondary to erosion by microbes.

It has the ICD 10 code of E11.621 

Diabetic foot ulcer symptoms

A wound with delayed healing mostly at the pressure points in the feet.

Offensive smelling pus.

Bleeding in some cases.

The patient will show manifestations of the insufficiency of the blood supply and in addition signs of nerve damage.

Diabetic foot ulcer treatment

It needs medical supervision because the doctor should remove the dead tissues and foreign particles as well as draining the pus if any.

He will prescribe antibiotics and anti-inflammatories in addition to anticlotting medications.

He may ask for an X-ray in order to determine the extension of the infection.

The diabetic foot ulcer needs frequent dressing and cleaning of the infection as well as continuous coverage by antibiotics.

Honey may help in wound healing.

Severe cases of diabetic foot ulcers need surgical treatment in order to remove dead tissues and drain the pus to prevent secondary bone infection.

More severe cases with gangrene need amputation of a toe or more, according to the site of the ulcer.

How to prevent it?

  • Controlling blood sugar as well as cholesterol.
  • Use comfortable diabetic shoes in and outdoors in addition to feet braces and cast.
  • Good trimming of toenails.
  • Frequent washing of feet.
  • Regular checkup of the soles by using a mirror.
  • Avoid smoking and alcohol.

Diabetic retinopathy

It is a diabetic complication that affects the retina in the eye. It takes about 10 years of being diabetic to develop.

Diabetic retinopathy is due to damage to the retinal blood vessels.

It carries ICD 10 code: ICD-10-CM Code E11.319

The risk factors are:

  • Improper control of the blood sugar level in addition to the cholesterol levels.
  • Smoking and hypertension.
  • Pregnancy.

Diabetic retinopathy symptoms

  • It may go without manifestations for a long time but then the patient will complain of difficulty in vision with haziness or blurred vision.
  • Impaired ability to determine colors.
  • Black spots in the visual field.
  • Fluctuating vision.
  • Nevertheless, it can result in loss of vision secondary to prolonged uncontrol of glucose level.

Treatment of diabetic retinopathy

  • Early cases need proper control of blood glucose as well as cholesterol.
  • Laser photocoagulation.
  • Vitrectomy.
  • Panretinal photocoagulation.
  • In addition, injection of medications into the eye have a role.

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