血管健康

Diabetes and 血管健康: Understanding the Connection

作者：Prasad Katta，医学博士
专业:内分泌学

Most people would be surprised to learn that dry, cracked feet could possibly lead to loss of use of a limb—maybe even amputation. 对于糖尿病患者来说， the slightest wound can become dangerous. In fact, the vast majority of toe and foot amputations performed in the U.S. 每年都是相关的 complications from foot wounds in people with diabetes.

At some point, most diabetics will develop some diabetic peripheral neuropathy – a loss of sensation in the feet. 这意味着糖尿病患者 may develop sores and other foot problems without realizing it.

With diabetes, the body cannot properly convert sugar from food into energy, causing sugar levels in the blood to rise. Normally the body changes sugars, starches, and other foods into glucose. Then insulin (a hormone produced in the pancreas) changes glucose into energy. 对于糖尿病，有 a lack of insulin or resistance to insulin, resulting in higher than normal 血糖水平.

Most diabetics die of stroke or heart attack—both of which are vascular 在自然界中. The major blood vessels (macrovascular) serve the heart, brain 和四肢. The minor blood vessels (microvascular) serve the eyes, kidneys and arteries to nerve endings. Damage to blood vessels may take the form of partial or complete blockage in the vessel. 这显然会损害 blood circulation, which can lead to many problems.

The wound-healing process, for example, depends on good circulation of 血液遍布全身. This is why a foot wound can become a chronic 拒绝愈合的伤口. In addition to painless wounds (due to lack of sensation), diabetics are more prone to infection.

感染 for diabetics may start with a small thing. 赤脚走路 when you have callouses or cracks in your feet is an opportunity for infection. This can be an infection on the skin, which is a soft tissue infection, or it can develop into a bone infection, which is more serious. 感染 can also follow any surgical procedure. A diabetic must be 护理fully monitored 手术后.

A diabetic patient particularly benefits from a multidisciplinary team 的医生. Prevention is the first step. 初级保健医生 will keep track of a patient’s “numbers”—blood pressure, cholesterol, and blood sugar levels. 这个医生会监督 and help the patient control these important health indicators.

But when a problem arises, a team of specialists, such as an endocrinologist, a diabetes educator, a physical therapist, a podiatrist, a wound 护理 specialist and, when needed a vascular surgeon, will provide the best 护理. With each specialist bringing their knowledge and experience to the case, the best treatment plan can then be created for a patient.

Some may be surprised to see a physical therapist in this group, but physical therapy plays an important role in healing. 例如，如果一个病人 has lost mobility for a period of time, the leg muscles can weaken or 萎缩. Without physical therapy, the chances of regaining the ability to walk are greatly hindered.

Prevention of diabetes is best, but if unsuccessful, managing diabetes 是至关重要的. This includes monitoring blood sugar levels and understanding which foods impact those levels. Regular exercise is also important and to enable that, vigilant foot 护理 是至关重要的.

A diabetic should perform foot exams regularly and any cuts or bruises—especially those not healing in a timely manner—should be seen by a doctor. Foot 护理 should also include:

• Wearing shoes and socks when walking, even indoors
• Following proper foot hygiene, 护理fully washing and drying the feet daily
• Having a podiatrist treat foot problems such as corns or calluses, rather than treating them with over-the-counter remedies
• Be very 护理ful of going to salons for pedicures; be certain to ask if they use disposable instruments or if instruments are sterilized after each use

Improving blood circulation and minimizing the risk of infection are goals of a diabetic’s treatment plan. Controlling diabetes now can help maintain long-term health and independence.

2020年1月发布