Diabetic foot threatens 18.6 million people every year, can lead to amputation

The prevalence of diabetic foot in the world is high, it can cause various problems, including amputation.

Jakarta - The incidence of diabetic foot reaches about 18.6 million people annually worldwide.Diabetic foot ulcers (DFU) are the most common complication of diabetes.

According to internal medicine specialist Viravan Hambali, this disease is estimated to occur in 15 percent of diabetic patients, mostly in elderly patients.Diabetic foot is an injury involving skin lesions, usually due to a combination of diabetic neuropathy, ischemia, and deformation, which leads to the development of necrosis (cell or tissue death) and ulceration (crater-shaped skin lesions) on the sole surface and lateral side of the big toe.

Diabetic feet can lead to amputation if left untreated.About 85 percent of lower limb amputation cases are related to diabetes.Judging by the degree of risk (lifetime risk), as many as 19 to 34 percent of all patients with diabetes mellitus (DM) have a diabetic foot.

"About 50-60 percent of diabetic foot wounds will be infected. Diabetes leads to 80-85 percent of diabetes-related amputations. About 20 percent of diabetic patients will need a leg amputation," said a doctor who serves patients at Pondok Indah Hospital - Puri Indah /, Thursday / 6 / January 2 / 2202 in January.

At the same time, mortality or death within five years is about 30-50 percent.In terms of recurrence, 42 percent of patients will have a diabetic foot condition within the first year and 65 percent of patients will have it within five years.

Diabetic feet often have no symptoms

Diabetic foot often does not show any symptoms until the bacteria enter the wound, causing an infection in the foot.

Diabetic foot is classified into three levels based on the degree of ulceration and type of infection: mild, moderate and severe.Treatment of diabetic foot depends on the severity of the wound/sore, ranging from antibiotic treatment to amputation.

Diabetic foot or diabetic foot ulcer is not a sudden condition, the process happens slowly. Often without realizing it. Due to prolonged high blood sugar levels, uncontrolled blood sugar can damage nerves and blood vessels. Especially in the legs, this combined damage can eventually cause ulcers that are difficult to heal.

One of the main causes is peripheral neuropathy, which is damage to the nerves in the feet.When the nerves are affected, the feet become numb or numb.Patients may not feel pain when pierced with sharp objects, exposed to heat, blisters may occur due to tight shoes.

"These small, invisible wounds are often overlooked. Because they keep walking and are under constant pressure, these wounds can swell and become serious," Wirawan said.

Some cases lead to Charcot fits.

In some cases, severe nerve damage can cause a condition called Charcot foot.

In this condition, the bones and joints of the legs are broken and easily injured.The legs may appear swollen or abnormally bent.This change in shape means that the body's weight is not distributed correctly when walking, causing new and visible pressure points that are prone to injury.

In addition to sensory nerves, diabetes can also damage the autonomic nerves, which control the body's automatic functions such as skin moisture and blood flow.This condition is known as diabetic foot autonomic dysfunction.

When the autonomic nerves are disturbed, the feet become very dry because they cannot sweat properly.Dry skin cracks (cracks) easily, and these small gaps in the skin are an entry point for germs that can cause infection.

Diabetes increases the risk of peripheral artery disease

On the other hand, diabetes also increases the risk of peripheral artery disease (PAD), specifically the narrowing of the arteries due to plaque buildup.

If the blood flow to the legs is reduced, the tissues cannot receive enough oxygen and nutrients.As a result, wound healing is difficult.Symptoms include cold, pale or bluish feet, pain when walking, and reduced hair growth on the legs.

The process of developing a diabetic foot (diabetic ulcer) is a combination of these factors.Small wounds that are not felt due to neuropathy, damaged skin due to autonomic nervous system disorders, pressure-increasing foot deformities, and poor blood flow all compound one another.Wounds that seem minor at first can develop into serious infections, even risking gangrene and amputation, if not treated properly.

Diabetic foot is a serious complication that, if not treated properly, can lead to amputation.The combination of nerve disorders and blood flow disorders is an important factor in the development of difficult-to-heal wounds.

"With early detection, good glycemic control, and appropriate vascular assessment and intervention, the risk of amputation can be avoided. A comprehensive multidisciplinary approach is key to maintaining quality of life in patients with diabetes," Wiravan concluded.