Diabetic Foot - Information Overview

Diabetic foot syndrome is a pathological condition in diabetes mellitus, characterized by damage to the skin, soft tissues, bones and joints and manifested by trophic ulcers, skin and joint changes and purulent-necrotic processes.

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Epidemiology of diabetic foot

Diabetic foot occurs in 10-25% of patients with diabetes mellitus and is the leading cause of lower limb amputations, which are performed 17-45 times more often in patients with diabetes mellitus than in people without carbohydrate metabolism disorders. It is this factor that determines early disability and mortality in patients with diabetes mellitus.

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Causes and pathogenesis of diabetic foot syndrome

The main reasons for the development of diabetic foot syndrome:

• peripheral neuropathy,
• lower limb ischemia;
• "minor" foot injury;
• foot deformation;
• infection.

Risk factors for developing diabetic foot syndrome:

• diabetic polyneuropathy at the stage of clinical manifestations;
• peripheral arterial diseases of any origin (including diabetic microangiopathy);
• foot deformation of any genesis;
• marked decrease in visual acuity, blindness;
• diabetic nephropathy;
• lonely living of elderly patients;
• alcohol abuse;
• smoking.

Cause and pathogenesis of diabetic foot

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Clinical signs and symptoms of diabetic foot syndrome

Clinical features of neuropathic and ischemic forms of diabetic foot syndrome are presented in the table.

In order to decide on the need for antibiotic therapy, timely recognition of systemic and local signs of wound infection is of great importance.

Systemic signs of wound infection:

• fever;
• intoxication;
• leukocytosis.

Symptoms of diabetic foot

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Diagnosis of diabetic foot syndrome

Early diagnostics of initial signs of damage to the peripheral nervous system, vascular system, soft tissues and bone structures of the lower extremities is aimed at preventing amnucleosis in patients with diabetes mellitus.

To conduct an initial diagnostic search, a general clinical examination and a minimal set of instrumental diagnostic methods are often sufficient to help determine the state of peripheral innervation and main arterial blood flow.

Diagnosis of diabetic foot

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Treatment of diabetic foot syndrome

Principles of conservative treatment of diabetic foot syndrome:

• compensation for diabetes mellitus;
• antibiotic therapy.

Principles of prevention of diabetic foot syndrome

• treatment of patients;
• regular wearing of orthopedic shoes;
• regular removal of hyperkeratosis

The amount of necessary medical care depends on the stage of the disease. Treatment of patients at stage I of diabetic foot syndrome consists of adequate treatment of the wound defect and the affected area of the foot. Patients with stage IA require a more detailed examination to assess the state of blood circulation. At stage II of diabetic foot syndrome, antibacterial therapy, local treatment and unloading of the limb are indicated. Patients with stages IV-V of diabetic foot syndrome require immediate hospitalization in a surgical hospital, complex conservative and surgical treatment.

Treatment of diabetic foot