糖尿病　フットケア

#diabetes #footcare

糖尿病患者さんに足病変が起こりやすいのは、糖尿病によって引き起こされる神経障害が原因です。　神経障害は、血液中の高濃度の糖分が末梢の神経を傷めてしまう病気で、糖尿病の比較的早い時期（罹患後５～10年）から発症し始めます。神経障害が起こると、まず手足がしびれたり、痛んだりします。さらに進行すると、感覚が鈍くなります。

神経障害とともに、もう１つ足病変の原因となるのが血流障害です。糖尿病が長年にわたると、全身の血管で動脈硬化が進み、心臓では狭心症や心筋梗塞、脳では脳梗塞の引き金になります。また、足だと末梢動脈へも症状がでてきます。足の動脈、特に膝下の動脈の内腔が狭くなって血液が流れにくくなります。すると、足の先まで十分な量の栄養や酸素が届かなくなります。動脈硬化がさらに進んで、足先などの細い血管が完全に詰まってしまうと、そこから先の部分の組織が死んで、潰瘍や壊疽を起こします。糖尿病による足病変は、神経障害を合併している患者さんに多く見られますが、そこに動脈硬化による血流障害が加わるとより重症化しやすくなります。

フットケアの目的は発症予防、再発予防に始まり、最終的に生命を守ることにつながります。清潔な足の状態を保ち、日常的に念入りにマッサージを行い、血行を促進を心がけることが大切です。いつまでも自分の足で歩けますように

Foot lesions are more likely to occur in diabetics because of neuropathy caused by diabetes.　Neuropathy is a disease in which high levels of sugar in the blood damage peripheral nerves and begins to develop relatively early in diabetes (5-10 years after the disease). When neuropathy occurs, the limbs first become numb and painful. As the disease progresses further, sensation becomes dull.

Along with neuropathy, another cause of foot lesions is impaired blood flow. Over time, diabetes can lead to atherosclerosis in blood vessels throughout the body, triggering angina pectoris and myocardial infarction in the heart and stroke in the brain. In the legs, symptoms can also occur in the peripheral arteries. The lumen of the arteries in the legs, especially below the knee, narrows, making it difficult for blood to flow. This prevents sufficient amounts of nutrients and oxygen from reaching the tips of the feet. If atherosclerosis progresses further and small blood vessels, such as those in the feet, become completely blocked, the tissue in the area beyond them dies, leading to ulcers and gangrene. Foot lesions caused by diabetes are more common in patients with neuropathy complications, but when blood flow obstruction due to atherosclerosis is added to this, the condition can become more severe.

The aim of foot care is to prevent the onset and recurrence of the disease, and ultimately to save lives. It is important to keep the feet clean, massage them carefully on a daily basis and try to stimulate blood circulation. May you walk on your own feet forever.