Clinical Approach to Diabetic Foot Problems

Abstract

Today, there are 382 million people living withdiabetes. A further 316 million with impaired glucose tolerance are at high risk from thedisease – an alarming number that is set to reach471 million by 2035. Diabetes is on the rise all overthe world and countries are struggling to keep pace (1). The evidence published in the IDF Diabetes Atlas proves that 80% of people with diabetes live in low and middle-income countries, and the socially disadvantaged in any country are the most vulnerable tothe disease (1). With the longevityof this population increasing, the prevalence of diabetesrelated complications will continue to rise.Foot disorders are a major source of morbidity and a leadingcause of hospitalization for persons with diabetes(2). Ulceration, infection, gangrene, and amputation are significantcomplications of the disease, estimated to cost billionsof dollars each year. Charcot foot, which of itself can leadto limbthreatening disorders, is another serious complicationof long-standing diabetes. In addition to improving themanagement of ulcers—the leading precursor to lowerextremity amputation in diabetic patients; cliniciansmust determine how to more effectively prevent ulceration (2).Although not all diabetic foot disorders can be prevented, itis possible to effect dramatic reductions in their incidenceand morbidity through appropriate evidence-based preventionand management protocols.Taking a multidisciplinary approach to diabetic foot disorders,many centers from around the world have notedconsistent improvement in limb salvage rates (2). Clinical Approach to Diabetic Foot Problems Page 3 Three major pedal complications of diabetes will be reviewed:diabetic foot ulcers, diabetic foot infections, and the diabeticCharcot foot.