[Interaction of ambulatory service, endocrinologic inpatient care and specialized departments in the treatment of patients with diabetes mellitus and foot lesions]. / Vzaiemodiia ambulatornoï sluzhby, endokrynolohichnoho statsionaru ta spetsializovanykh viddilen' v likuvanni khvorykh na tsukrovyi diabet z urazhenniam stopy.

Three-year experience of management and treatment of 3553 patients with diabetes mellitus (DM), including 500--insulindependent and 3053--insulinindependent cases, was summarized. Divisional endocrinologist is choosing patients with DM and high risk of the diabetic foot syndrome (DFS) or its signs. In presence of risk factors for DFS occurrence the patient is trained to care of foot and petty surgical manipulations are performed: to cut off toenails, treatment of superficial affection of skin and fungous affection of skin, determination of the foot setting, correcting insole to fit footwear if necessary. If all kinds of sensitivity are reduced on the foot in the absence of its deformity and ulcer the patient is recommended once a year to treat in endocrinological stationary and to consult surgeon in Centre of treatment of DM complications. If the foot blood supply is disordered, ulcer occurrs the patient is referred to surgeon. In 2132 (60%) patients risk factors or DFS signs were revealed. Surgical treatment for purulent-necrotic affection was conducted in 61 patients (2.9% of the patients number with risk factors of the foot affection), including intervention on the foot--in 50 (2.3%), high amputation of lower extremity--in 11 (0.6%).