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Diabetic Foot Care
49yrs old female, type2 diabetes for 7 yrs, bilateral great toe ulcers, non healing for last 1 year, HbA1c-9% , VPT and HCP-grossly impaired, ABI:right-1.01, left-0.92 1. what other information do you require from this patient? 2. what is the primary goal of treatment for her? 3. do you think her diabetes control is adequate , and if not what might you suggest? 4. what teaching would you do with this patient? 5. what are the plans regarding treatment of her ulcers?
Tue, 26 Apr 2011
broad spectrum antibiotics , daily dressing well control of blood suger will diefinitely improve her ulcers.
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Hba1c is 9. That means her sugars are shooting up even on the current treatment. Insulin dose must be titrated after monitoring sugars 5 times a day by glucometer.
Chances are, there is abnormal pressure on the ulcer site while walking. Change of footware (preferably diabetic footware) after consultation of a foot surgeon is advised. This is called offloading. Until the load is lifted off the ulcer, it won't heal. Worst case scenario - if the blood vessels are involved, there is a slim chances of the ulcer getting healed very rapidly.
Ideally I'd like her to have a visit to an institute dedicated to diabetes where she could be evaluated by foot surgeon and a diabetologist, both.
Chances are, there is abnormal pressure on the ulcer site while walking. Change of footware (preferably diabetic footware) after consultation of a foot surgeon is advised. This is called offloading. Until the load is lifted off the ulcer, it won't heal. Worst case scenario - if the blood vessels are involved, there is a slim chances of the ulcer getting healed very rapidly.
Ideally I'd like her to have a visit to an institute dedicated to diabetes where she could be evaluated by foot surgeon and a diabetologist, both.
I find this answer helpful
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