DIABETIC FOOT: REPORT OF EXPERIENCE OF ACADEMICS OF MEDICINE IN EARLY DETECTION IN A REFERENCE CENTER

Abstract

DIABETES MELLITUS IS ONE OF THE MOST PREVALENT CHRONIC DISEASES IN BRAZIL, CHARACTERIZED BY CHANGES IN BLOOD GLUCOSE LEVELS. THE DISEASE IS A CAUSE OF VASCULAR AND NEUROLOGICAL MICRO-INJURIES. AMONG THE MOST COMMON COMPLICATIONS IS THE DIABETIC FOOT. THE EXPERIMENT WAS BASED ON A MASTERS PROJECT, WHICH AIMS TO PREVENT DIABETIC FOOT. THE OBJECTIVE OF THE PRESENT WORK IS TO REPORT ON THE EXPERIENCE OF THIS DATA COLLECTION, EVIDENCING THE IMPORTANCE OF EARLY DIAGNOSIS OF CHARACTERISTIC CHANGES OF THIS COMPLICATION. THIS IS AN ACCOUNT OF EXPERIENCE ABOUT AN ACTIVITY DEVELOPED BY FIVE STUDENTS AND A LECTURER IN THE MEDICAL SCHOOL OF THE UNIVERSITY CENTER OF ANAPOLIS-UNIEVANGELICA. THIS PROJECT WAS CARRIED OUT FROM WEEKLY MEETINGS AT THE JUNDIA� HEALTH UNIT DOCTOR ILION FLEURY JUNIOR (OSEGO) TO COLLECT DATA, AS WELL AS OCCASIONAL MEETINGS WITH THE TEACHER TO DISCUSS THE DATA AND ELABORATE THE EXPERIENCE REPORT. IN THE SECOND PART OF THE QUESTIONNAIRE, PHYSICAL EXAMINATION WAS PERFORMED, ASSESSING WHETHER FOOTWEAR WAS ADEQUATE, FOOT HYGIENE, DEFORMITY, MYCOSIS, MOISTURE, PILIFICATION, SKIN APPEARANCE, HYPERKERATOSIS AND PRESENCE OF PREVIOUS AMPUTATION. IN ADDITION, A VASCULAR AND NEUROLOGICAL PHYSICAL EXAMINATION WAS PERFORMED TO CLASSIFY THE DIABETIC FOOT AS TO ITS ETIOPATHOGENESIS. THE CRITERIA EVALUATED WERE: ULCERS, PULSES, CAPILLARY FILLING TIME AND BLOOD PRESSURE; SENSITIVITY TO MONOFILAMENT, PAIN SENSITIVITY WITH A PIN, THERMAL AND VIBRATION WITH THE TUNING FORK AND AQUILEU REFLEX. FINALLY, THE MUSCLE STRENGTH IN THE CALF AND IN THE ANTERIOR TIBIAL MUSCLE WAS EVALUATED, AND THE PATIENT WAS ASKED TO WALK ON THE TOES AND HEELS. IN THIS CONTEXT, IT BECOMES CLEAR, THEREFORE, AFTER THE CONSULTATIONS AND MEETINGS WITH THE COUNSELOR, THAT PREVENTION IN PRIMARY CARE IS UNSATISFACTORY. ALSO, IT IS CLEAR THE NEED FOR SPECIFIC EVALUATION OF THE DIABETIC FOOT, SINCE IT IS SOMETHING THAT MOST PATIENTS TEND TO IGNORE, OFTEN FOR LACK OF KNOWLEDGE OF THE CONSEQUENCES, AND THAT CAN CAUSE IRREVERSIBLE SEQUELS AS OBSERVED BY STUDENTS IN CASES OF AMPUTATION .