A diabetic foot is a long term complication of diabetes mellitus and includes conditions that develop and affect the feet of an individual with diabetes mellitus. This is usually as a consequence of damaged nerve supply (diabetic neuropathy), peripheral arterial disease, or a combination of the two.
It is not a medical emergency, although early intervention is warranted to prevent complications and morbidity.
It develops as a result of reduced peripheral nerve function and diabetic neuropathy, which causes a reduced ability to feel pain. This can exist along with a reduced and poor blood circulation to the extremities. This works in two ways, as it firstly hinders the ability to recognize minor injuries, and secondly, these injuries go on to become serious infections as a result of the poor blood supply and delayed wound healing.
The following are the risk factors:
It can be triggered by a small injury that may go unnoticed.
The symptoms and signs of a diabetic foot may include the following:
It may present with the following types of infections:
The following investigations may be done:
A diagnosis of diabetic foot is established based on medical history, clinical evaluation, and results of the investigations done.
The treatment of diabetic foot depends on the severity of the condition and the type of infections or complications that are present. It may include medical and surgical management. Vascular management, infection management and prevention, and pressure relief are essential in the management of a diabetic foot.
Medical management of a diabetic foot may include the following:
Interventional procedures such as follows may be required in the management of a diabetic foot that has progressed to chronic osteomyelitis are:
Some measures that can be taken to prevent this disease may include the following:
The following complications may be seen:
The prognosis for a diabetic foot depends on the severity of the complications that are associated with it. The cellulitis has a better prognosis than chronic osteomyelitis, and the morbidity and mortality increase when systemic infections, peripheral artery disease, ischemic heart disease, decreased kidney function are present in an individual with a diabetic foot.
It is advisable to seek medical attention if any of the signs and symptoms of a diabetic foot are noticed.
Hospitalization may be required for the management of a diabetic foot that presents with complications such as infections.
It is advisable for all individuals with diabetes mellitus to schedule regular visits with a Podiatrist to have their feet examined, in addition to following proper self foot care.
It will be attended by specialists from the departments of diabetology/endocrinology, infectious diseases, and general surgery.