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Suggest treatment for open wounds in feet of type 1 diabetic patient

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Posted on Sat, 23 May 2015
Question: Hi, I am asking in regards to my mother who has T1 diabetes. Her feet problems started two months ago and she was treaded in Sweden about a week ago by getting teo larger blood vessels in her leg expanded.

Now, the open wounds are left and I am 1) looking for recommendations on the best treatment possible as well as 2) looking to understand the severaty of the current status and risk for amputation. If the risk of amputation is high I would like to understand better what the options are and weather it would be wiser to wait and see progress or seeking for treatment sooner than later asap.

Best regards,
Concerned son
doctor
Answered by Dr. Shehzad Topiwala (2 hours later)
Brief Answer:
Emergency

Detailed Answer:
I am sorry to learn about your mother's foot status.

From the pictures it does not look good at all. In fact, it seems like a medical emergency to have her feet looked at by a team comprising:

Vascular surgeon
General Surgeon
Endocrinologist

It entails a thorough physical examination of the feet, and in general too.

Blood tests, and X rays of the feet may be helpful with further testing such as MRI/ MR Angiograms, will guide the next best step.

This will be a complex medical situation that demands intensive care.

Please take her to the nearest emergency room
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shehzad Topiwala (5 minutes later)
Hi,

Problem is this has already been done. She was released from the hospital yesterday. I am very critical to such decision and are now looking for second opinions.

The suggested care for her right now is to be careful and to get her bandages changed every other day starting om Monday.
doctor
Answered by Dr. Shehzad Topiwala (12 hours later)
Brief Answer:
Follow up

Detailed Answer:
I understand your need for a second opinion.

Upon studying the photographs it appears to need close care, such as daily examinations to see if it is healing well.

Foot care is going to be critical. Controlling her blood glucoses is another very important task. Aim to keep her diabetes stable, avoiding fluctuations in sugar levels from low to high.

Keeping blood pressure and cholesterol in check is also helpful. If she smokes, she must stop.

There are some medications to help improve blood flow and circulation. Check with her doctor if she is a candidate for these type of medications.

Finally seek a professional opinion from a surgeon experienced in dealing with 'diabetic feet'. Online forums like these will have the limitation of not being able to physically examine the patient. Having the opportunity to assess the nerve function in the feet along with blood-flow is crucial in the decision making process.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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Suggest treatment for open wounds in feet of type 1 diabetic patient

Brief Answer: Emergency Detailed Answer: I am sorry to learn about your mother's foot status. From the pictures it does not look good at all. In fact, it seems like a medical emergency to have her feet looked at by a team comprising: Vascular surgeon General Surgeon Endocrinologist It entails a thorough physical examination of the feet, and in general too. Blood tests, and X rays of the feet may be helpful with further testing such as MRI/ MR Angiograms, will guide the next best step. This will be a complex medical situation that demands intensive care. Please take her to the nearest emergency room