Diabetic Peripheral Neuropathy - Online Diabetes：糖尿病周围神经病变的糖尿病-在线.ppt

* Once you have done your assessment it is important to categorize people according to their level of risk as this will determine the management plan. * In the 1990s, the late Roger Pecararo described the pathway to amputation. In this scenario, a person with diabetes has neuropathy and/or peripheral vascular disease. A trauma may occur that causes ulceration. If this fails to heal, infection and osteomyelitis can ensue. If the infection is not arrested, the patient might ultimately require an amputation. While this is a common pathway, in some hot and humid countries, in people with poor glycaemic control, underlying neuropathy and/or vascular disease do not need to be present; people can progress quickly from trauma to infection to amputation. * This slide says it all… This figure is terrifying especially when we know that up to 85% of amputations are preventable with early identification of the at-risk foot and prompt treatment by a skilled multidisciplinary footcare team. * Demonstrate how to do a foot assessment. Ask participants to form pairs and do a foot assessment on each other. * Diabetic foot disease is a major cause of morbidity and mortality in people with diabetes. It accounts for much of the cost of diabetes to health budgets and contributes to the majority of diabetes-related hospitalizations. The two principal factors that contribute to the high-risk diabetic foot are: Peripheral neuropathy – damage to the nerves that serve the lower limbs and hands. Peripheral vascular disease, which affects the larger vessels of the lower limbs. In most people, a combination of peripheral neuropathy and peripheral vascular disease co-exists. Although diabetes is the most common cause of non-traumatic amputation worldwide, amputation should not be considered an inevitable consequence of diabetes. Many cases are preventable through early detection and prompt and appropriate treatment by a skilled multidisciplinary team. * Some interesting but frigh