diabetic foot neuropathy Flashcards
what are the complications of diabetes that predispose to foot disease?
- neuropathy (sensory, motor, autonomic)
- peripheral vascular disease
how do you test sensory function?
via mono-filament
when the filament bends, 10g of pressure has been applied which should be felt by patient
what is the pathway to foot ulceration?
- sensory neuropathy
- motor neuropathy
- limited join mobility
- autonomic neuropathy
- peripheral vascular disease
- trauma
- reduced resistance to infection
- other (diabetic complications)
what happens in sensory neuropathy?
- cannot feel monofilament
- ulcers due to abnormal pressures
what happens in motor neuropathy?
- imbalance of extensors/flexors so foot is abnormal shape
- ulcers due to abnormal pressures
what happens in limited joint mobility?
causes joint immobility
cannot put hands flat against each other
what happens in autonomic neuropathy?
no sweating so skin dries out and you get ulcers
what happens in peripheral vascular disease?
blood flow is compromised to lower limbs
what happens in trauma?
repeated or minor episodes
from a diabetics perspective, what must be managed?
- hyperglycaemia
- hypertension
- dyslipidaemia
- stop smoking
- education
what are the preventative management options?
- controlling diabetes
- attend chiropodist
- take care when feet will get hot
- inspecting feet daily
- cut nails straight across
- never walk barefoot
what is the management of foot ulceration?
- relief of pressure (bed rest and redistribution of pressure)
- antibiotics
- debridement
- re-vascularisation
- amputation
what is charcot foot?
- bones orientated in abnormal way
- “rocker bottom foot”
- painful to non-diabetics but not for diabetics due to sensory neuropathy
- deformity due to loss of join-position sense
- abnormal shape predisposes to osteomyelitis
what is the difference between osteomyelitis and charcot foot?
- osteomyelitis: bone infection
- charcot foot: destruction of joints
