{"id":20,"date":"2021-01-28T05:08:05","date_gmt":"2021-01-28T05:08:05","guid":{"rendered":"http:\/\/blogs.sld.cu\/piediabetico\/?page_id=20"},"modified":"2022-03-18T17:26:20","modified_gmt":"2022-03-18T17:26:20","slug":"diagnostico","status":"publish","type":"page","link":"https:\/\/blogs.sld.cu\/piediabetico\/diagnostico\/","title":{"rendered":"Diagn\u00f3stico\/Tratamiento"},"content":{"rendered":"<p>El diagn\u00f3stico del pie diab\u00e9tico es basicamente <strong>cl\u00ednico. <\/strong><\/p>\n<p>Se debe realizar un interrogatorio y examen f\u00edsico exhaustivo, encaminado a detectar los factores de riesgo del pie diab\u00e9tico:<\/p>\n<p><span dir=\"ltr\" role=\"presentation\">-la edad del paciente<\/span><\/p>\n<p><span dir=\"ltr\" role=\"presentation\">-el tiempo de evoluci<\/span><span dir=\"ltr\" role=\"presentation\">\u00f3<\/span><span dir=\"ltr\" role=\"presentation\">n<\/span><\/p>\n<p><span dir=\"ltr\" role=\"presentation\">-grado de control <\/span>de la glucemia<\/p>\n<p>&#8211;<span dir=\"ltr\" role=\"presentation\">antecedentes de complicaciones<\/span><\/p>\n<p><span dir=\"ltr\" role=\"presentation\">-antecedentes <\/span><span dir=\"ltr\" role=\"presentation\">de <\/span><span dir=\"ltr\" role=\"presentation\">\u00fa<\/span><span dir=\"ltr\" role=\"presentation\">lceras, amputaci<\/span><span dir=\"ltr\" role=\"presentation\">\u00f3<\/span><span dir=\"ltr\" role=\"presentation\">n, <\/span><span dir=\"ltr\" role=\"presentation\">infecciones o traumas en los pies<\/span><\/p>\n<p>&#8211;<span dir=\"ltr\" role=\"presentation\">ingesti<\/span><span dir=\"ltr\" role=\"presentation\">\u00f3<\/span><span dir=\"ltr\" role=\"presentation\">n de<\/span> medicamentos<\/p>\n<p>&#8211;<span dir=\"ltr\" role=\"presentation\">h<\/span><span dir=\"ltr\" role=\"presentation\">\u00e1<\/span><span dir=\"ltr\" role=\"presentation\">bitos t<\/span><span dir=\"ltr\" role=\"presentation\">\u00f3<\/span><span dir=\"ltr\" role=\"presentation\">xicos del paciente: <\/span><span dir=\"ltr\" role=\"presentation\">consumo <\/span><span dir=\"ltr\" role=\"presentation\">de alcohol, cigarros o<\/span> <span dir=\"ltr\" role=\"presentation\">tabacos y su<\/span><br role=\"presentation\" \/><span dir=\"ltr\" role=\"presentation\">magnitud<\/span><\/p>\n<p>-e<span dir=\"ltr\" role=\"presentation\">stado <\/span><span dir=\"ltr\" role=\"presentation\">socioecon<\/span><span dir=\"ltr\" role=\"presentation\">\u00f3<\/span><span dir=\"ltr\" role=\"presentation\">mico y el grado de apoyo <\/span><span dir=\"ltr\" role=\"presentation\">familiar para enfrentar los problemas de<\/span><br role=\"presentation\" \/><span dir=\"ltr\" role=\"presentation\">salud<\/span><\/p>\n<p><span dir=\"ltr\" role=\"presentation\"> -se deben i<\/span><span dir=\"ltr\" role=\"presentation\">dentificar <\/span><span dir=\"ltr\" role=\"presentation\">s<\/span><span dir=\"ltr\" role=\"presentation\">\u00ed<\/span><span dir=\"ltr\" role=\"presentation\">ntomas de neuropat<\/span><span dir=\"ltr\" role=\"presentation\">\u00ed<\/span><span dir=\"ltr\" role=\"presentation\">a, angiopat<\/span><span dir=\"ltr\" role=\"presentation\">\u00ed<\/span><span dir=\"ltr\" role=\"presentation\">a o sepsis <\/span><span dir=\"ltr\" role=\"presentation\">que pudieran ser las causas del pie<\/span><br role=\"presentation\" \/><span dir=\"ltr\" role=\"presentation\">diab<\/span><span dir=\"ltr\" role=\"presentation\">\u00e9<\/span><span dir=\"ltr\" role=\"presentation\">tico.<\/span><br role=\"presentation\" \/><br role=\"presentation\" \/><span dir=\"ltr\" role=\"presentation\">-si existen\u00a0 deformidades anat<\/span><span dir=\"ltr\" role=\"presentation\">\u00f3<\/span><span dir=\"ltr\" role=\"presentation\">micas en pies.<\/span><\/p>\n<p>-s<span dir=\"ltr\" role=\"presentation\">obrepeso corporal u obesidad<\/span><\/p>\n<p>&#8211;<span dir=\"ltr\" role=\"presentation\">el uso de <\/span><span dir=\"ltr\" role=\"presentation\">calzado inadecuado.\u00a0<\/span><\/p>\n<ol>\n<li><span dir=\"ltr\" role=\"presentation\">Examen de las extremidades<\/span><br role=\"presentation\" \/><span dir=\"ltr\" role=\"presentation\">inferiores <\/span>podr\u00eda <span dir=\"ltr\" role=\"presentation\">arrojar los hallazgos<\/span><br role=\"presentation\" \/><span dir=\"ltr\" role=\"presentation\">cl<\/span><span dir=\"ltr\" role=\"presentation\">\u00ed<\/span><span dir=\"ltr\" role=\"presentation\">nicos siguientes:<\/span><br role=\"presentation\" \/><span dir=\"ltr\" role=\"presentation\">1. Pie neurop<\/span><span dir=\"ltr\" role=\"presentation\">\u00e1<\/span><span dir=\"ltr\" role=\"presentation\">tico<\/span><br role=\"presentation\" \/><span dir=\"ltr\" role=\"presentation\">El pie tiene temperatura conservada,<\/span><br role=\"presentation\" \/><span dir=\"ltr\" role=\"presentation\">puede haber parestesia, hiperestesia,<\/span><br role=\"presentation\" \/><span dir=\"ltr\" role=\"presentation\">hipoestesia o anestesia, hiporreflexia o<\/span><br role=\"presentation\" \/><span dir=\"ltr\" role=\"presentation\">arreflexia, anhidrosis, piel fisurada y seca,<\/span><br role=\"presentation\" \/><span dir=\"ltr\" role=\"presentation\">deformidades pod<\/span><span dir=\"ltr\" role=\"presentation\">\u00e1<\/span><span dir=\"ltr\" role=\"presentation\">licas, hiperqueratosis<\/span><br role=\"presentation\" \/><span dir=\"ltr\" role=\"presentation\">plantar, atrofia muscular, dilataciones<\/span><br role=\"presentation\" \/><span dir=\"ltr\" role=\"presentation\">venosas y<\/span> <span dir=\"ltr\" role=\"presentation\">\u00fa<\/span><span dir=\"ltr\" role=\"presentation\">lceras generalmente en el<\/span><br role=\"presentation\" \/><span dir=\"ltr\" role=\"presentation\">tal<\/span><span dir=\"ltr\" role=\"presentation\">\u00f3<\/span><span dir=\"ltr\" role=\"presentation\">n, mal<\/span> <span dir=\"ltr\" role=\"presentation\">\u00e9<\/span><span dir=\"ltr\" role=\"presentation\">olo, cara superior de<\/span><br role=\"presentation\" \/><span dir=\"ltr\" role=\"presentation\">articulaci<\/span><span dir=\"ltr\" role=\"presentation\">\u00f3<\/span><span dir=\"ltr\" role=\"presentation\">n de los dedos, cabeza del<\/span><br role=\"presentation\" \/><span dir=\"ltr\" role=\"presentation\">quinto y primer metatarsianos,<\/span> <span dir=\"ltr\" role=\"presentation\">\u00e1<\/span><span dir=\"ltr\" role=\"presentation\">pice de<\/span><br role=\"presentation\" \/><span dir=\"ltr\" role=\"presentation\">los dedos; tiene borde circular con callo<\/span><br role=\"presentation\" \/><span dir=\"ltr\" role=\"presentation\">alrededor.6 La lesi<\/span><span dir=\"ltr\" role=\"presentation\">\u00f3<\/span><span dir=\"ltr\" role=\"presentation\">n inicial puede ser un<\/span><br role=\"presentation\" \/><span dir=\"ltr\" role=\"presentation\">mal perforante plantar, asociado o no a<\/span><br role=\"presentation\" \/><span dir=\"ltr\" role=\"presentation\">sepsis. Puede haber osteoartropat<\/span><span dir=\"ltr\" role=\"presentation\">\u00ed<\/span><span dir=\"ltr\" role=\"presentation\">a.<\/span><br role=\"presentation\" \/>r\u00e1 al m\u00e9dico, muchos elementos de la situaci\u00f3n del paciente, y los controles glic\u00e9micos.<\/li>\n<\/ol>\n<h2><\/h2>\n<h2><\/h2>\n<h2>Tratamiento<a href=\"http:\/\/blogs.sld.cu\/piediabetico\/files\/2021\/01\/pie-diabeticoevitable.jpg\"><img loading=\"lazy\" class=\"wp-image-38 size-full aligncenter\" src=\"http:\/\/blogs.sld.cu\/piediabetico\/files\/2021\/01\/pie-diabeticoevitable.jpg\" alt=\"Tratamiento del pie diab\u00e9tico\" width=\"219\" height=\"158\" \/><\/a><\/h2>\n<p>Cuando un paciente o familiar, detecta que hay alteraciones en el pie, lo primero es contactar con el m\u00e9dico de la familia que le indicar\u00e1 el camino a seguir. Los m\u00e9dicos tienen identificados a todos los pacientes diab\u00e9ticos de su \u00e1rea. En los policl\u00ednicos, est\u00e1 habilitada una consulta de pie diab\u00e9tico) ya que esta complicaci\u00f3n de la diabetes, requiere de la opini\u00f3n de varios especialistas.<\/p>\n<p>&nbsp;<\/p>\n<h3><a href=\"https:\/\/blogs.sld.cu\/ttopiediabetico\" target=\"_blank\" rel=\"noopener\">Tratamiento m\u00e8dico quir\u00f9rgico del pie diab\u00e8tico<\/a><\/h3>\n<p>Dr. Jos\u00e8 I. Fern\u00e0ndez Montequin<\/p>\n","protected":false},"excerpt":{"rendered":"<p>El diagn\u00f3stico del pie diab\u00e9tico es basicamente cl\u00ednico. Se debe realizar un interrogatorio y examen f\u00edsico exhaustivo, encaminado a detectar los factores de riesgo del pie diab\u00e9tico: -la edad del paciente -el tiempo de evoluci\u00f3n -grado de control de la glucemia &#8211;antecedentes de complicaciones -antecedentes de \u00falceras, amputaci\u00f3n, infecciones o traumas en los pies &#8211;ingesti\u00f3n [&hellip;]<\/p>\n","protected":false},"author":208,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/blogs.sld.cu\/piediabetico\/wp-json\/wp\/v2\/pages\/20"}],"collection":[{"href":"https:\/\/blogs.sld.cu\/piediabetico\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/blogs.sld.cu\/piediabetico\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.sld.cu\/piediabetico\/wp-json\/wp\/v2\/users\/208"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.sld.cu\/piediabetico\/wp-json\/wp\/v2\/comments?post=20"}],"version-history":[{"count":18,"href":"https:\/\/blogs.sld.cu\/piediabetico\/wp-json\/wp\/v2\/pages\/20\/revisions"}],"predecessor-version":[{"id":178,"href":"https:\/\/blogs.sld.cu\/piediabetico\/wp-json\/wp\/v2\/pages\/20\/revisions\/178"}],"wp:attachment":[{"href":"https:\/\/blogs.sld.cu\/piediabetico\/wp-json\/wp\/v2\/media?parent=20"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}