Avoidable amputation of diabetic feet

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Many foot amputations in diabetics would be avoidable

Every year around 28,000 so-called diabetic feet have to be amputated in this country. The majority of these amputations would be avoidable if the diabetics were given adequate medical care, explained the director of the Institute for Clinical Pharmacology at the University of Rostock, Bernd Drewelow, in the run-up to the 12th Rostock Anti-Infectious Disease next weekend.

As a result of the significantly poorer blood circulation in the feet as a result of the diabetes, bacteria that settle in open wounds can only be inadequately controlled and serious infections threaten, said Bernd Drewelow. Diabetics therefore suffer from an increased susceptibility to infection, which can lead to dangerous ulcers in the area of ​​the feet even with the smallest of injuries, which in the worst case requires an amputation of the foot, the expert reported. However, "far more than half" of the approximately 28,000 amputations of diabetic feet per year can be avoided if medical treatment is started early, emphasized the director of the Institute for Clinical Pharmacology.

Causes of diabetic feet The development of the clinical picture of a diabetic foot is usually preceded by infections caused by bacteria, which penetrate into the body when injured and cannot be adequately combated by the immune system due to poor circulation. The living conditions in the poorly healing wounds favor the growth of the bacteria and there are massive ulcers that often require an amputation of the foot, explained Bernd Drewelow.

In addition to the circulatory disorders, according to the expert, other factors favor the risk of infections in the area of ​​the feet in diabetics. In the course of the disease, the nerves are often damaged, making the feet less sensitive to shock and pressure. The risk of injury increases and often small wounds are not noticed by those affected, warned the Drewelow. As the eyesight of diabetics is also relatively often impaired, they often register the inflammation that occurs only too late, the director of the Institute for Clinical Pharmacology continues.

Medical treatment important for avoiding amputation According to Bernd Drewelow, difficulties in the treatment of the diabetic foot result, for example, from the way medical personnel and doctors deal with the disease. "Many doctors, including nurses and those affected, would be disgusted with such feet themselves." Accordingly, treatment is often hesitant. But avoiding amputation requires immediate action, according to Drewelow. As a first step, the dead tissue should be removed urgently to prevent the infection from spreading further, the specialist explained. Thereafter, antibiotic-based treatment is recommended, although the medication is often difficult to reach the affected area due to poor tissue blood circulation, according to the director of the Institute for Clinical Pharmacology. After the bacterial strains have been identified, Drewelow emphasized that the treatment that needs to be selected from the approximately 100 available antibiotics must be selected.

Promoting blood circulation in the feet The specialist recommends that diabetics do something themselves to improve the blood circulation in the feet. Drewelow explained that physical activities and exercise can have significant positive effects. An improvement in blood circulation in the legs and feet can also be achieved, for example, with the help of so-called Kneipp cures (Kneipp casts and treading water). In order to avoid infections and the associated diabetic foot, according to Bernd Drewelow, careful foot care is also particularly important. (fp)

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