The initial stage of gangrene of the lower extremities in diabetes mellitus

Diabetes mellitus is an insidious disease that dramatically changes a person’s life. It is impossible to get rid of the disease forever, but if you adjust your lifestyle, eat a balanced diet and take the recommended drugs, you can stop the development of severe complications.

The most serious consequence of the disease is a diabetic foot, when a patient has a whole complex of harmful changes: the structure of joints and bones is disturbed, ulcers on the legs are revealed, blood circulation is disturbed as a result of atherosclerotic changes.

If you do not take action promptly and do not undergo the correct treatment, against the background of this list of complications, an even more serious ailment is observed – gangrene in diabetes mellitus. Gangrene is the necrosis of cells in any internal organ or part of the body, such as the legs.

It is necessary to figure out how to prevent gangrene of the lower extremities (as in the photo), what are the first symptoms that indicate its formation? And also find out what to do in this case, and what ointments will help?

Gangrene in diabetes mellitus

As already mentioned, gangrene is the death of body tissues, as a result of which living tissues and blood are infected through toxic substances, which in turn leads to severe damage to the internal organs of a person – the kidneys, heart, liver, lungs and others. If this condition is not treated, then the result is one – a fatal outcome.

Late visits to a doctor, improper treatment, ignorance of the disease – all this leads to the fact that medications can no longer cope with the situation, an extremely radical measure will help, like amputation of a leg or foot.

As a rule, with diabetes mellitus gangrene of the lower extremities develops – it can affect a finger or several feet, but in the most advanced cases, when there is no treatment, it is necessary to amputate the leg to the knee, and sometimes even higher.

Gangrene tends to spread throughout the body, and in order to save human life, one has to resort to such a method as amputation. In medical practice, factors are distinguished that can lead to gangrene of the legs (as in the photo):

  • The ischemic form of gangrene begins due to atherosclerotic changes in the human body, as a result of which blood vessels are clogged, as a result, full blood circulation is disrupted. The result of this process: a deficiency of circulating blood and incoming oxygen, which leads to the death of the affected tissues.
  • Diabetic foot (as pictured). The initial stage of development is characterized by ulcers on the foot or lower leg. The process of tissue regeneration is very slow, wounds begin to become infected, and gangrene of an infectious nature develops.
  • Polyneuropathy develops as a result of a failure in the level of glucose in the human body, which is carried out in all cells of the nervous system.
  • The defeat of large vessels due to atherosclerosis, as a result, thrombosis is detected, and the person develops gangrene of the lower extremities.

The causes of gangrene include a weakening of the immune system. In the overwhelming majority of cases, the patient’s medical history indicates that this condition is caused not by one reason, but by a number of factors. At the same time, arising, factors reinforce each other’s influence, which leads to a severe stage of the disease.

Complications with legs can affect anyone with a history of any type of diabetes mellitus. The patient has wounds and injuries on his legs, but since the pain threshold is significantly reduced, the patient does not pay attention to this, he simply does not feel painful sensations.

Signs of gangrene in diabetes mellitus

The first symptoms of gangrene of the lower extremities are difficult to establish, since the legs have lost their previous sensitivity.

Nevertheless, there are some signals from the body that should be emphasized. After all, it is they who will help to recognize the development of the disease, and in time to prevent the development of tissue necrosis (as in the photo).

The first symptoms are the following: a feeling of heaviness in the legs, chronic fatigue of the legs, slight tingling sensations are not excluded, as well as a feeling of numbness in the legs; joint and muscle pains appear, the foot may be deformed.

The most visual sign of the onset of a pathological process is a change in the color of the lower limb, its temperature regime. Such symptoms can be manifested by redness of the limb, or the foot becomes too pale and blue. She will always be cold to the touch, her swelling occurs, calluses appear.

If you do not start treatment at an early stage in order to neutralize negative symptoms and reverse the process, the following clinical picture is revealed:

  1. The affected parts of the legs always hurt, the painful sensations do not subside, while they tend to intensify.
  2. The skin of the foot in some areas becomes purple or black
  3. Infection is added to tissue necrosis, mainly this situation is often observed with wet gangrene.
  4. Purulent masses can be released from the affected area, while abundant.

Against the background of the listed symptoms, other negative signs appear, such as an increase in the temperature of the body, a feverish state, a person is sick, he has a headache, and dizziness is present. Gangrene in humans against the background of diabetes mellitus is of two types:

  • Dry.
  • Wet.

Dry gangrene of the foot develops gradually and is most often diagnosed in elderly patients. Over a long period of time, the human skin becomes wrinkled and dries up. Dry gangrene is characterized by the following symptoms:

  1. Pallor of the lower extremities.
  2. The systematic occurrence of painful sensations in the legs.
  3. Loss of sensation in the legs.
  4. Swelling of the legs.

Wet gangrene of the foot (as in the photo) in the overwhelming majority of medical cases is diagnosed in obese and sick people. Its course is much more difficult when compared with the dry form of the disease. Due to the fact that soft tissues do not dry out, as with dry gangrene, they contain a huge amount of fat cells, the foot becomes covered with purulent formations.

Against the background of a purulent process, decay products and toxic substances are released into the patient’s body, which only leads to an aggravation of the situation, and the chances of a favorable outcome are reduced.

Gangrene: what to do and how to treat it?

Wet gangrene implies only two methods of therapy. In the first option, the doctor tries to cope with medication to restore the patient’s limbs and prevent amputation.

In the second case, treatment is recommended through surgery. As medical practice shows, it is this option that is the most effective and efficient.

At the initial stage of the disease, a huge volume of fluid is injected into the patient’s body – subcutaneously, intravenously and intramuscularly. Usually, the doctor uses glucose, isotonic solution, blood substitutes as a liquid. To reduce painful sensations, the doctor prescribes ointments and creams that have an analgesic effect.

Dead cells are removed through surgery. After the intervention, the patient is recommended to take a huge amount of antibiotics.

Treatment of the disease can be carried out by such methods:

  • Microsurgical procedure. For intervention, the doctor uses instruments that are capable of penetrating a blood vessel, no more than 2 millimeters thick, and “pushing” it to the required size.
  • Angioplasty and stenting. In this case, small-sized “balloons” are installed in the vessels, which expand them, as a result of which full blood circulation is restored. This procedure must be done under sterile conditions, and only in modern clinics.

If the stage of the disease is neglected, and apart from amputation, there is no way out, the doctor tries to reduce the level of amputation as much as possible. That is, a person’s leg is not completely amputated, but all the above-described methods of treatment are applied to the part that remains.

Many patients are interested in how long people live with such a diagnosis. In general, we can say that with proper and adequate treatment, and even with amputation, in 50% of situations it is possible to stop tissue necrosis, and a person will live a full life.

It is worth noting that even at the initial stage of the disease, one cannot self-medicate, no ointments and gels will restore full blood circulation, the situation will only worsen.

In addition, the doctor recommends taking various vitamin complexes and other drugs that help restore the human immune system, increase its natural defenses.

How long does the treatment take? There is no exact answer, the treatment and its duration depend on the patient’s condition, the stage of the disease, as well as on the diagnoses, which include his medical history.

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