Gangrene is the local death (death) of tissues in a living organism. It is dangerous because it poisons the blood with cadaveric toxins and leads to the development of deadly complications from the vital organs: kidneys, lungs, liver and heart. Gangrene in diabetes most often occurs if diabetic foot syndrome develops, and the patient does not pay the necessary attention to his treatment.
Surgical amputation saw
Gangrene in diabetes most often affects the toes or feet entirely. It is the most severe form of diabetic foot syndrome. It can develop for one of 2 reasons:
- The blood supply to the tissues of the legs is very much disturbed, because the blood vessels are almost completely blocked due to atherosclerosis. This is called ischemic gangrene.
- Diabetic foot syndrome has caused ulcers on the feet or lower legs, which do not heal for a long time. Gangrene occurs when anaerobic bacteria begin to multiply in these wounds. This is called infectious gangrene.
What causes leg problems with diabetes?
Type 1 and type 2 diabetes are a huge threat to the patient’s feet. Diabetics often have ulcers and wounds on the legs that do not heal for a long time, fester and can lead to amputation or death from gangrene. This problem is faced by 12-16% of diabetics, it is millions of people around the world. For reasons related to diabetes, much more lower limbs are amputated than for all other reasons, including crashes of cars and motorcycles.
However, ulcers on the legs, which in diabetes develop into festering wounds, never occur suddenly. They appear on the places where the skin of the legs was damaged. If you follow the rules of foot care in diabetes, you can reduce the risk and keep the ability to move “on your own two feet”.
If a person with diabetes has an experience of more than 5 years, and all this time he has high blood sugar, then he probably already partially or completely lost his sensation in his legs. Feet no longer feel pain, pressure, high and low temperature. This is because chronically elevated blood sugar poisons, and then kills the nerves that control sensitivity in the feet. Also, the nerves that are responsible for sweating on the skin of the feet die. After that, the skin stops sweating, it becomes dry and often cracks. Dry skin is more prone to damage and heals worse than when it is moisturized normally. Cracks in the skin become a haven for dangerous bacteria.
Why are wounds on the feet of diabetics so poorly healed Because chronically elevated blood sugar interferes with the blood circulation in large and small vessels that feed the tissues of the legs. In order to heal a wound, it may be necessary to have an intensive blood flow, 15 times higher than normal. If the body can not provide normal blood flow to the injury site, then it does not heal, but on the contrary only worsens. Gangrene may develop, and the infection will spread throughout the leg. Increasingly, an infection that causes gangrene in diabetes does not respond to antibiotics, because the bacteria have developed resistance to them.
Dry gangrene in diabetes
In diabetes, gangrene can be dry or wet. Dry gangrene occurs when the patency of the blood vessels of the lower extremities decreases gradually over several years. Thus, the body has the time to adapt, to develop protective mechanisms. Dry gangrene in diabetes usually affects the toes. Tissues that gradually die off are not affected by the infection.
With dry gangrene, there may be severe pain at first, but later the affected toes lose sensitivity. They begin to acquire a mummified appearance, visually sharply different from healthy tissues. The smell is absent. Since the absorption of toxins into the blood is very small, the general condition of the patient does not change.
Dry gangrene in diabetes is not life-threatening. Amputation is carried out for cosmetic reasons and for prophylaxis in order to prevent infection and to prevent gangrene from going wet.
Wet gangrene has opposite signs. If anaerobic microbes infect a wound with diabetic foot syndrome, they multiply in it very quickly. Fabrics increase in volume, they have a specific blue-violet or greenish color. The affected lower extremity acquires the form of a corpse decomposition, and the process spreads with lightning speed up the leg.
Since the space under the skin is filled with hydrogen sulfide, a specific sound called crepitus is heard when pressed. An unpleasant putrid odor emanates from the site affected by gangrene. The patient's condition is severe due to severe intoxication. With wet gangrene, only an urgent amputation can save the life of a patient with diabetes, if time is not lost.
Prevention and treatment of gangrene in diabetes
First of all, you need to learn and carefully follow the rules for foot care in diabetes. Legs must be carefully protected to minimize the risk of injury. Wearing orthopedic shoes is highly recommended. A diabetic patient himself or someone from a family member should examine the feet every night for any changes. The soles should be carefully inspected with a mirror.
If new abrasions, blisters, blisters, ulcers, etc. appear on the leg, consult a doctor immediately. You can not allow anyone (even a doctor) to cut corns. This is the main cause of ulcers that lead to gangrene and amputation of the foot. Examine all the shoes that a diabetic wears to identify the inconvenience caused by the formation of corns.
If dry gangrene develops in diabetes, the treatment is to perform a surgical operation on the vessels. Such an operation, if successful, can restore the patency of the blood vessels that feed the affected leg. This often allows patients to avoid amputation and retain the ability to walk “on their own two feet”.
With a wet infectious gangrene, so far there is no treatment other than emergency amputation. Moreover, it is carried out much higher than the place where the process of decay has reached. Remember that in such a situation, to abandon amputation is to condemn yourself to death, albeit quick, but painful.
So, we learned what dry and wet gangrene is in diabetes. If you carefully treat diabetic foot syndrome, then you can certainly avoid this terrible complication. Run a type 2 diabetes treatment program or a type 1 diabetes treatment program.
Read also articles:
- Diabetic foot syndrome and its treatment for the prevention of amputation;
- Diabetes feet - what to do;
- How to lower blood sugar to normal is the best way.