In one minute, two operations (amputations) are performed on a diabetic’s foot in the world,
per day – 2880 people
per month – 86,400 people
for the year -1036800 people (one million)
This number would be significantly less if the means of prevention and rehabilitation proposed by the “Health Studio – OUR SUPPORT” were used.
SEARCHING FOR TRUTH FOR THE GOOD OF MAN
World science today seems to already have enough knowledge to solve certain problems in medicine. However, statistics from various sources indicate an increase in problems, not a decrease. Diabetes mellitus is no exception to this unfortunate rule. According to the World Health Organization (WHO), today about 171 million people in the world suffer from diabetes, and the number of such patients is increasing every day. According to WHO forecasts, by 2030 the number of people with diabetes will increase to 366 million.
We will not delve into global data but will tell the story of regional significance, which is what world statistics are made up of. In 2005, the Rivne Regional Association for the Protection of Citizens with Diabetes held a conference on diabetes problems. The author of the article, the holder of a patent for the method of accurate footprints, was also invited to this event.
At the very beginning of the conference, a quick survey was conducted, during which they asked those who have problems with their feet and musculoskeletal system to raise their hands. Almost the entire audience raised their hands. Then they asked to raise their hands to those who are taking any actions aimed at solving these problems. There were no hands raised and no positive response was given!
This gives us the right to conclude that patients suffering from diabetes did not pay due attention to their feet. What changed in 2006, after information was released about how to protect your feet by making individual orthopedic insoles using the method of pneumatic molding of a diabetic’s footprint?
Unfortunately, we are only discussing the problem of diabetic feet, but there has not been any proper initiative at least on the part of those who are primarily interested in preserving their feet – those suffering from diabetes – have not been felt! Information support from some endocrinologists did not appear, as desired.
What’s the matter? Is the method not relevant or is there no desire to accept what the International Diabetes Federation (IDF) tirelessly talks about?
The IDF has published a World Guide to Type 2 Diabetes itself, which provides valuable advice on foot care: Assess foot health in people with diabetes as part of an annual assessment (history of foot ulcers or amputations, symptoms of peripheral arterial disease, difficulty walking independently). foot care due to a physical condition or visual disturbance; the presence of foot deformities (hammer or claw toes, bony protrusions) and footwear; visual signs of neuropathy (dry skin, calluses, dilated veins) or initial ischemia of the foot; deformation or damage to the nails); determination of neuropathy using a monofilament thread (10 g) or a graduated tuning fork (with a frequency of 128 Hz); as an additional option for quantitative assessment, you can use a biothesiometer (critical level value for the risk of foot ulcers > 25 V), atraumatic injection (with a blunt needle), palpation of the pulse on the foot (on the dorsal pedis and posterior tibial artery) and determination of the capillary refill rate; in the case when arterial pulsation decreases to a degree that does not allow a quantitative assessment of pathological changes, a Doppler study is performed to determine the ankle-brachial index (for occlusive vascular disease, the index is <0.9).
In addition, each patient with diabetes should discuss the rationale for foot screening as part of the self-foot care education process, agree on a foot care plan based on the annual foot screening, determine the type of information needed, and provide foot care education tailored to the patient’s individual needs. needs and risk of developing foot ulcers and amputations. It is necessary to classify the condition in accordance with the examination data as follows: no additional risk (sensitivity is not reduced, there are no signs of peripheral artery disease and other risk factors); presence of risk (neuropathy or other single risk factor identified); high risk (reduced sensation and foot deformity or signs of peripheral artery disease); very high risk (history of foot ulcer or previous amputation); foot ulcer or infection (presence of a foot ulcer).
The patient must be treated depending on the degree of damage according to the classification:
1) no additional risk: agree on a treatment plan with each patient, including training in foot care;
2) presence of risk: schedule regular (approximately every 6 months) examinations performed by a team of foot care specialists. During each examination: examine both feet; ensure local treatment is carried out in accordance with indications; evaluate the features of shoes and give appropriate recommendations; provide additional training in foot care;
3) High risk: Schedule frequent (every 3-6 months) examinations by a team of foot care specialists. At each examination: examine both feet; ensure local treatment is carried out in accordance with indications; evaluate the features of shoes; give recommendations, and if indicated, ensure the wearing of special insoles and shoes; decide on the need for vascular examination or referral to a specialist; determine the nature of the information needed and provide appropriate additional training in foot care;
4) Foot ulcer or infection (including conditions requiring emergency foot care): Refer the patient to a multidisciplinary foot care team within 24 hours to:
– appropriate treatment of the wound, dressing, and surgical treatment of the wound in accordance with the indications;
– assessing the feasibility of systemic antibiotic therapy (often long-term) for foot phlegmosis or infection involving the bone, depending on the indications; penicillins, macrolides, clindamycin, or metronidazole are used as first-line drugs according to indications. Examples of second-line drugs include ciprofloxacin or co-amoxiclav (a combination of amoxicillin and clavulanic acid);
– optimal distribution of pressure on the foot (immobilizing unloading bandage if there are indications and no contraindications), directions for examination and treatment for vascular insufficiency;
– studies with a probe to the bone (to assess its damage), radiography, scanning, magnetic resonance imaging, and biopsy, if there are indications in connection with suspected osteomyelitis;
– optimal blood glucose control;
– selection of special shoes and orthopedic devices (for example, insoles), as well as discussion of issues of preventing relapses after healing of the ulcer.
Amputation should only be performed in the following cases:
1) detailed assessment of the condition of blood vessels by angiologists;
2) the impossibility of eliminating ischemic pain at rest with the help of analgesics or revascularization;
3) the impossibility of treating a life-threatening foot infection with other methods;
4) a non-healing ulcer, the consequences of which are more severe for the patient than those caused by amputation.
The foot care team includes physicians who specialize in diabetic foot problems, patient educators, and individuals with formal training in foot care (usually podiatrists or registered nurses).
Foot ulcers and limb amputations are important factors associated with health problems and healthcare costs associated with diabetes. Issues of primary prevention of conditions underlying nerve and vascular damage are discussed elsewhere in the manual. Secondary interventions in patients with risk factors can help reduce the severity of these conditions and reduce the costs of their treatment for both patients with diabetes and society,
Because of the potential to improve health outcomes and reduce health care costs, the available evidence regarding diabetic foot care has been extensively and extensively reviewed in recent years.
The findings are largely consistent: proper routine testing to identify those at risk, frequent routine screening of patients with identified risk factors, and aggressive treatment of patients with foot ulcers and infections can more than pay off in terms of both health and financial costs. associated with amputation. Foot care education for all patients, additional education for those at higher risk, and surgical intervention in the presence of critical ischemia (including if it is contributing to the formation of a foot ulcer) are also generally accepted evidence-based recommendations.
In Ukraine, on the basis of the Rivne Regional Endocrinological Dispensary, conditions have been created to provide the necessary assistance to patients with diabetic foot syndrome. The presence of a diabetic foot office together with an orthopedic office and individual production of orthopedic insoles in one dispensary room provides undeniable positive results in providing care to patients with diabetic feet. In addition, the medical base with qualified medical personnel brings the Rivne Regional Endocrinological Dispensary to a leading position in Ukraine in terms of the uniqueness of providing comprehensive medical care to patients with diabetes.
What are the capabilities of an orthopedic care office with custom-made orthopedic insoles?
Firstly, this is the strict implementation of MDF recommendations to ensure the wearing of special insoles and shoes; selection of special shoes and orthopedic devices (insoles), as well as discussion of issues of preventing relapses after healing of the ulcer. The foot care team includes a diabetic foot physician, a patient educator, and formal training in foot care.
Secondly, we have received a Ukrainian patent for a method of forming impressions of individual orthopedic insoles on two chambers, each of which has an elastic surface, filled with a fluid medium and adapted to the load of the patient’s weight, which consists in applying at least one specified elastic surface preheated to a temperature of plastic deformation of a workpiece made of thermoplastic material, loading of said elastic surfaces with the weight of the patient’s body, regulation of fluid pressure in at least one chamber to place the patient in a physiologically correct position and holding said workpiece under load for the time necessary for the resulting print to lose its plasticity. Air is supplied as a fluid into the chambers, and the air pressure is adjusted in the corresponding chamber until the standing patient assumes a position in which the conventional straight line between the upper points of the wings of the pelvic bones has a horizontal direction.
This technique using air more accurately conveys the patient’s footprint and is more gentle on the plantar surface of the foot, where there may be ulcerative damage to the surface, various amputations, and injuries. Therefore, the condition of the patient’s foot, the presence of abrasions, corns, calluses, cracks, injuries, and amputations is taken into account, and correction of the foot and the entire musculoskeletal system is carried out.
The cause of the functional difference in the length of the lower extremities (FLDLD), in which the patient’s overall center of gravity (CG) is displaced, causing the incorrect position of the spine (scoliosis), is eliminated. Bringing the foot and musculoskeletal system into a functionally correct position helps prevent various injuries, and harmonize the functioning of internal organs, including improving the functioning of the endocrine system.
Practice shows that the individual production of orthopedic insoles using the exact imprint of the patient’s foot is structurally different from the mass approach to the problem and is an objective method necessary for the prevention and treatment of diabetic foot problems. Doctors note the feasibility of the practical application of the method of forming impressions of individual orthopedic insoles in medical practice (therapy, pediatrics, neurology, traumatology, obstetrics, sports medicine, etc.), including for problems with the feet and the entire musculoskeletal system.
You can order custom orthopedic insoles at:
Ukraine, Rivne, st. Kurchatova, 6, Regional Endocrinological Dispensary, office for orthopedic care and production of orthopedic insoles.
Vladimir TARASOV, Rivne
Phone: +380678833730
Chief editor Volodymyr Ivanovich PANKIV
Head of the editorial board Tronko M.D.
Editorial Board
Babak O.Ya. (Kharkiv)
Bobirova L.Ye. (Poltava)
Bodnar P.M. (Kyiv)
Bolshova O.V. (Kyiv)
Bondarenko V.O. (Kharkiv)
Bondarenko L.O. (Kharkiv)
Botsyurko V.I. (Ivano-Frankivsk)
Vlasenko M.V. (Vinnytsia)
Gendelek G.F. (Odessa)
Gladkova A.I. (Kharkiv)
Gulchiy M.V. (Kyiv)
Demchenko O.M. (Kharkiv)
Zelinska N.B. (Kyiv)
Zubkova S.T. (Kyiv)
Zueva N.O. (Kyiv)
Epshtein O.V. (Kyiv)
Efimov A.S. (Kyiv)
Karachentsev Yu.I. (Kharkiv)
Kirilyuk M.L. (Odessa)
Kovalenko V.M. (Kyiv)
Kozakov O.V. (Kharkiv)
Komisarenko I.V. (Kyiv)
Korpachov V.V. (Kyiv)
Kravchenko V.I. (Kyiv)
Larin O.S. (Kyiv)
Luchitsky E.V. (Kyiv)
May tributary V.G. (Kyiv)
Mankovsky B.M. (Kyiv)
Maslyanko V.A. (Chernivtsi)
Medved V.I. (Kyiv)
Melekhovets O.K. (Sumi)
Naumenko V.G. (Kyiv)
Neiko E.M. (Ivano-Frankivsk)
Netyazhenko V.Z. (Kyiv)
Oliynik V.A. (Kyiv)
Paschko N.V. (Ternopil)
Pertseva T.O. (Dnipropetrovsk)
Pirig L.A. (Kyiv)
Pichkar I.I. (Uzhgorod)
Pishak V.P. (Chernivtsi)
Plekhova O.I. (Kharkiv)
Poltorak V.V. (Kharkiv)
Prilutsky O.S. (Donetsk)
Pristupyuk O.M. (Kyiv)
Reznikov O.G. (Kyiv)
Selivanova K.F. (Simferopol)
Sergienko O.O. (Lviv)
Sidorchuk I.Y. (Chernivtsi)
Turchin I.S. (Kyiv)
Fabri Z.Y. (Uzhgorod)
Khizhnyak O.O. (Kyiv)
Cherenko S.M. (Kyiv)
Shved M.I. (Ternopil)
Shіdlovsky V.O. (Ternopil)
L.V. scale (Lugansk)
Head of the editorial office Ferranni E. (Pisa, Italy)
Editorial Council
Ametov O.S. (Moscow, Russian Federation)
Anestiadi Z.G. (Chisinau, Moldova)
Aristarkhov V.G. (Ryazan, Russian Federation)
Balabolkin M.I. (Moscow, Russian Federation)
Gerasimov G.A. (Moscow, Russian Federation)
Gordeladze M.R. (Tbilisi, Georgia)
Danilova L.I. (Minsk, Belarus)
Dsdov I.I. (Moscow, Russian Federation)
Ismailov S. (Tashkent, Uzbekistan)
Kalinin A.P. (Moscow, Russian Federation)
Mamedgasanov R.M. (Baku, Azerbaijan)
Mamedov M.N. (Moscow, Russian Federation)
Melnichenko G.A. (Moscow, Russian Federation)
Metreveli D. (Tbilisi, Georgia)
Mokhort T.V. (Minsk, Belarus)
Romanchishen A.P. (St. Petersburg, Russian Federation)
Sviridenko N.Yu. (Moscow, Russian Federation)
Fadeev V.V. (Moscow, Russian Federation)
Troshina K.A. (Moscow, Russian Federation)
Kholodova O.O. (Minsk, Belarus)
Shestakova M.V. (Moscow, Russian Federation)
Prof. P. Beck-Peccoz (Milan, Italy)
R.S. Brown (Boston, USA)
Prof. F. Delange (ICCIDD)
Prof. E. Fliers (Amsterdam, Holland)
Prof. Ph. Home(Newcastle, Great Britain)
Prof. D. Hryhorczuk (Chicago, USA)
Prof. Gang Hu (Helsinki, Finland)
Prof. D. Koev (Varna, Bulgaria)
Prof. G.E. Krassas (Thessaloniki, Greece)
Prof. Janusz A. Nauman(Warsaw, Poland)
Prof. E. Standl (Munich, Germany)
Prof. I. Szabolcs (Budapest, Ugorshchina)
Prof. Jan Taton (Warsaw, Poland)
Rh. Williams (Swansea, Great Britain)
Prof. H. Yki-Jarvinen(Helsinki, Finland)
Prof. E. Zbranca (Iasi, Romania)
Prof. S. Zgliczynski(Warsaw, Poland)
An article by Vladimir Tarasov, owner of the method and Patents of Ukraine for the individual production of orthopedic insoles, Prize-winner of the All-Ukrainian Competition of inventors and innovators “Philips: smart and Simple”, winner of the “People’s Choice Award” chosen at the Competition by a majority of votes of visitors (100 thousand Kyiv residents and guests of the city), the winner of the “European Medical Prize” can be regarded as recognition of the feasibility of introducing into medical practice the proposed method of accurate footprints in Ukraine and throughout the world!
This is confirmed by the decision to publish materials in the International Endocrinological Journal (a specialized scientific and practical journal), by the agreed decision of Ukrainian officials, represented by the Chief Endocrinologist of Ukraine V.I. Pankiv. and specialists in the field of medicine of Ukraine: Chairman of the editorial board Tronko M.D. and 55 members of the editorial board, specialists in the field of medicine from countries around the world: Chairman of the editorial board Ferrannini E. (Pisa, Italy) and 38 members of the editorial board from 18 countries (Russia, Moldova, Georgia, Belarus, Uzbekistan, Azerbaijan, Italy, USA, ICCIDD, Holland, Great Britain, Finland, Bulgaria, Greece, Poland, Germany, Hungary, Romania