Treatment and rehabilitation of patients with complications of diabetes on lower legs primarily refers to the treatment of diabetic foot. The most common symptoms of diabetic foot are: sensations such as pins and needles, cold or warmth in toes and foo, pain. Patients may also have loss of protective sensibility in the foot or the lower leg. Due to pain in lower leg(s) during the locomotion patients have to stop often and rest so the pain ceases. Such intermittent pain can be a consequence of the peripheral arterial diseases (PAD) which develop earlier in persons with diabetes. Some patients can have both types of symptoms.
Treatment and rehabilitation services for patients with diabetic complication on lower extremities are available to in- and out patients, depending on the clinical presentation, multidisciplinary team assessment, and patient’s preference.
In treatment and rehabilitation we use the following:
– physical therapy (therapeutic exercises, treadmill, vacuum compression therapy, carbotherapy, galvanic baths, magneto therapy, phototherapy, occupational therapy)
– Hyperbaric oxygenation therapy (HBOT).
– pharmacotherapy in consultations of clinical pharmacist and internist: antibiotic therapy, chronic pain pharmacotherapy, chronic wound treatment with special dressings, etc.
– education of patients about nutrition and diabetic foot care (as a secondary prevention measure)
– psychosocial support
In evaluation of patients with diabetic foot and peripheral arterial disease (PAD) we use: 6-minutes’ walking test, measurement of the pain-free walking distance, ankle-brachial / Doppler index, EMNG and CDS of blood vessels, transcutaneous oximetry and tissue circulation measurement.