Diabetic foot complications

Diabetic foot complications, including ulcers and infections, are a common and costly complication of diabetes mellitus.

The majority of diabetic foot ulcers are caused by repetitive trauma sustained during activity on a structurally abnormal, insensate foot.

Ulcers act as a portal of entry for bacterial infections. Preventing and/or healing ulcers helps prevent infections and thereby minimises risk of limb loss.

Initial evaluation and early management may be by primary care providers; however, there should be a low threshold to refer to an interdisciplinary diabetic foot care clinic or inpatient unit. This is particularly true if there is any a) tissue loss b) loss of sensation or c) signs of peripheral artery disease.

Leg amputation should be avoidable in the majority of cases and is rarely the first-choice option for ambulatory patients.

The term "diabetic foot complications" encompasses the conditions of diabetic foot ulcer (i.e., a full-thickness epithelial defect below/distal to the ankle),[1]Schaper NC. Diabetic foot ulcer classification system for research purposes: a progress report on criteria for including patients in research studies. Diabetes Metab Res Rev. 2004 May-Jun;20(suppl 1):S90-5. http://www.ncbi.nlm.nih.gov/pubmed/15150820?tool=bestpractice.com and diabetic foot infections (i.e., any soft-tissue or bone infection occurring in the diabetic foot, including osteomyelitis).