Mr. Yang, 65, reported that he had a dry mouth and itching 10 years ago, and his fasting blood sugar rose to 9 during a physical examination3 mmol l, glycosylated hemoglobin 71. Postprandial blood sugar 98mmol L, and he was diagnosed with type 2 diabetes.
At first, doctors prescribed metformin hydrochloride tablets and repaglinide tablets orally**, but glycemic control was not ideal.
After 3 months of control, fasting blood glucose was 71 mmol l, postprandial blood glucose 136 mmol L, glycosylated hemoglobin 84％。
He refused to receive insulin** and has since interrupted his medication**, adjusted his medication on his own, and has not returned to the clinic.
3 years ago, he gradually developed blurred vision, but no special **.
1 year ago,Numbness in both lower limbs, obvious on the left side, no fever, no nightPain at restand other accompanying symptoms.
He has a history of hyperlipidemia and hypertension in the past, and his blood pressure is controlled at about 130 80mmHg.
After learning about Mr. Yang's basic condition, the doctor conducted a series of examinations for him, and checked his fasting blood sugar in the outpatient clinic.1261 mmol l, glycosylated hemoglobin 103％；Physical examination: BP was 160 90 mmHg, clear speech, respiratory clarity in both lungs, no dry and wet rales, heart rate 73 beats, rhythm, no murmur in the auscultation area of each valvle of the heart, soft abdomen, no tenderness, rebound tenderness and muscle tension, no palpation of the liver and spleen, mild edema of both lower limbs, weakened fluctuations of the left dorsalis pedis artery, normal fluctuations of the right dorsalis pedis artery, and double Pap sign (-).
Primary diagnosis: type 2 diabetes mellitus, diabetic peripheral neuropathy, diabetic retinopathy;②Grade 2 hypertension, very high-risk;Hyperlipidemia;Hospitalization** is recommended
After being admitted to the hospital, Mr. Yang finally agreed to receive insulin** after repeated persuasion by doctors.
After the **, Mr. Yang's blood sugar dropped, numbness in his hands and feet, blurred vision disappeared, his condition was under control, and all indicators were improving.
Doctor reminds: Diabetes mellitus is a metabolic disease characterized by chronic hyperglycemia caused by a variety of **It is accompanied by a series of metabolic disorders such as sugar, protein, fat, water and electrolytes in the body caused by insulin secretion or insulin action defects.
Clinically, hyperglycemia is the main mark, and common symptoms are polydipsia, polyuria, polyphagia and weight lossTherefore, if you find that you have these symptoms, you must seek medical attention in time and be active**.
With the improvement of people's living standards in China, changes in dietary structure and lifestyle have led to a rapid increase in diseases related to glucose and lipid metabolism disordersDiabetes has become a global health threat, with as many as 1There are 200 million people, and the number of pre-diabetic people has exceeded 200 million, and the trend is younger.
The main manifestation of diabetes is an increase in blood sugar, people can monitor the blood sugar level in the body through a blood glucose meter, when the blood sugar in the body continues to rise, it will also cause special manifestations of the body's "target organs", such as some subtle changes in the feet.
When these 6 manifestations appear in the feet, most of them may be due to excessive blood sugar, please seek medical attention as soon as possible, don't drag it into diabetic foot!
Itching, pigmentation of the feet
If long-term blood sugar control is poor, it will cause the plasma osmolality to be higher than the surrounding tissues, causing the body to lose water, triggering the patient's early feet**Symptoms such as itching, dryness, waxy changes, poor elasticity, hair loss, pale or purplish skin or pigmentation
Numbness in the feet
When blood sugar is not effectively controlled, symptoms of high blood sugar may occur, which may lead to a build-up of blood sugar in the blood vesselsleads to the endBlood circulationThere is a disorder that affects the health of the feet, causing numbness in the feet.
Pain in the feet
Long-term high blood sugar can lead to diabetic neuropathy and vascular disease, especially painful neuropathy, which can lead to symptoms of foot pain and foot numbnessThe affected area usually has symptoms such as pinprick and burning pain, which will be aggravated at night or when exposed to heat.
Swelling of the feet
High blood sugar can cause damage to blood vessels in the feet and water retention, leading to edema of the foot tissues.
This edema can make the feet feel heavy and fatigue easilyand increases the risk of foot injuries.
Foot ulcers
If the blood sugar is high for a long time, it will damage the nerves and blood vessels, and the circulation of the lower limbs will be worse, especially the blood supply to the feet, if there is not enough blood**,Small ** damage or trauma cannot be healed in time, which can easily lead to bacterial infection, which can manifest as symptoms such as redness, swelling, pain and pus.
If the ulcer gets worse, or if it doesn't heal for a long time, it can eventually lead to the development of the diabetic foot.
Therefore, once you have such a manifestation, it is best to pay attention to the blood sugar changes in time and go to the hospital to treat the wound, because if the small ulcer is not treated in time, it is likely to cause the patient to lose his toes or even a leg.
Joint deformity
Long-term hyperglycemia will lead to acral dystrophy, muscle atrophy, and loss of normal traction tension balance between the flexor and extensor musclesThe bones sink and cause the interphalangeal joints to bend, resulting in foot deformities such as arched feet, mallet toes, and chicken claw toes.
In addition to the above symptoms,In some patients, long-term hyperglycemia can cause peripheral nerve lesions, and the sensation of pain, temperature, and pressure will be abnormalSome diabetics may not feel pain, and when normal people feel hot, diabetics will feel warm, and they are prone to foot burns without knowing it; Abnormal feeling of pressure, even if a small stone is pressed in the shoe, the ** is worn out and there are blisters, diabetics do not know, they will not take off their shoes and deal with the stones like normal people, and then continue to walk.
How to prevent diabetic foot when the temperature drops in winter?
When the weather becomes colder in winter, blood sugar fluctuations will be more common, and it is easy to induce various complications.
In addition to blood sugar control, patients also need comprehensive care, among which foot care is particularly crucial, because improper care is likely to lead to diabetic foot ulcers and infections.
So, how can patients take good foot care?
1.Wash your feet: Wash your feet with warm water every day, use flexible soap to avoid irritation; Before washing, test the temperature with your hands or a thermometer to prevent the water temperature from being too high and burning your feet；People with dry feet can use skin care such as moisturizing lotionto prevent drying, chapping
2.Avoid burns:Because diabetic patients are often unable to judge the temperature due to paresthesia in the feet, therefore,In the cold winter season, diabetic patients should not warm their feet by the stove, and do not use hot water bottles, electric blankets, foot warmers, etc.
3.Socks should not be worn too tight:Diabetics themselves have poor blood circulationSocks that are too tight tend to bind blood vessels and muscles, not only affects blood circulation,It can also cause muscle or tissue necrosis over time
Socks should pay attention to water absorption and good air permeabilityAt the same time, the socks should be washed in time to keep them clean.
4.Choose the right shoes: When choosing shoes, pay attention to the wide toe cap, soft toe, good breathability, and appropriate size.
5.Check your feet often:Inspect the feet and toes in bright areas and examine the soles of the feet with a mirrorPay attention to whether there are corns, calluses, athlete's foot, lacerations, blisters, blood blisters, redness and swelling, etc, usually observe whether the gait is abnormal, whether the shoes are worn, and whether there are foreign objects protruding into the shoes, blood vessel pulsation, hair growth, temperature and capillary refill, observe the deformity and tissue destruction of the foot and heel, etc., once the abnormality is found, it is necessary to be active.
6.Stick to foot exercises:Exercise can improve blood circulation in the lower limbs and prevent the occurrence of foot lesionsIt is recommended that patients should stick to foot exercise for 30-60 minutes a day.
7.Regular hospital check-ups: annually for diabetic patientsAt leastPerform a thorough examination of both lower extremities below the kneeFor high-risk groups, regular check-ups should be carried out to avoid aggravation of early symptoms.
In addition,If there is a foot wound, it must be treated in time and seek medical attention in time without delay.