Diabetic foot: importance in the practice of family medicine and own clinical experience

Abstract

According to statistical data concerning the spread of the diabetes mellitus (DM) it is expected the increase up to 439 million patients for the year of 2030. The rate of cardiovascular morbidity and death in patients with DM (according to clinical investigations) is 2-4 times higher, than in patients without DM. Investigations also show, that feet ulcers presence in DM patients is connected to higher death rate of such patients. Foot ulceration continues to be the main comorbidity and diabetes manifestation and injure 15% to 25% of DM type 1 and 2 patients during lifetime. Importance of observation of such a patients is based on the fact, that approximately 85% of all amputations in DM patients are connected with foot ulcer. Therefore, the cost of treatment of the ulcers of diabetic foot and amputations for the health care system is enormous. Yet according to current scientific data 40% to 85% of diabetic foot amputations could be avoided in early identification and preventive maintenance, such as discharging care and hygienic care, very important aspects of primary level activity. Classical pathogenetic triad of diabetic foot syndrome includes ischemia, neuropathy and infection. Article presents own clinical observations among numerous department of Kiev City Clinical Hospital #8 experience of the case of diabetic foot, which is accompanied with obvious symptomatology. In particular, patient A., male of 67 years, was admitted with complies on right lower limb pain, oedema and red colour of right foot, accompanied with pain upon walking. During two month before he suffered from the pain in right lower limb. Severe trophic disorder of the 4 right foot finger appeared one month before current admittance. Necrectomy of the 4 right foot finger was performed. Basing on mentioned clinical material at state and English languages education of students and interns we use analysis of widely spread and rare clinical cases and treatment aspects at practical studies.