Foot Problems in Diabetes: An Overview
Open Access
- 1 August 2004
- journal article
- review article
- Published by Oxford University Press (OUP) in Clinical Infectious Diseases
- Vol. 39 (Supplement), S73-S82
- https://doi.org/10.1086/383266
Abstract
Diabetes is the leading cause of nontraumatic lower-extremity amputations in the United States. Most amputations are preceded by an ulcer, and ulcers are costly in their own right. Most ulcers are neuropathic in etiology and plantar in location. They occur typically at sites of high mechanical loading because of repetitive trauma in people with loss of pain sensation. In an adequately perfused limb, such ulcers are not difficult to heal. When they are properly mechanically off-loaded, ∼90% of these wounds heal in ∼6 weeks. The reference standard off-loading device is the total contact cast, but other reasonably efficacious methods exist. Screening and implementation of preventive measures in the high-risk patient are highly recommended and can reduce the incidence of ulceration. All patients with diabetes should be screened annually for loss of protective sensation, with the 10-g Semmes-Weinstein monofilament being the easiest tool to use. Education to prevent complications should be implemented for all patients with loss of protective sensation.Keywords
This publication has 36 references indexed in Scilit:
- The Health Care Costs of Diabetic Peripheral Neuropathy in the U.S.Diabetes Care, 2003
- How should peripheral neuropathy be assessed in people with diabetes in primary care? A population‐based comparison of four measuresDiabetic Medicine, 2003
- The North‐West Diabetes Foot Care Study: incidence of, and risk factors for, new diabetic foot ulceration in a community‐based patient cohortDiabetic Medicine, 2002
- Off-Loading the Diabetic Foot WoundDiabetes Care, 2001
- Geographic Variation of Lower-Extremity Major Amputation in Individuals With and Without Diabetes in the Medicare PopulationDiabetes Care, 2001
- What the Practising Physician Should Know about Diabetic Foot BiomechanicsPublished by Wiley ,2000
- The burden of diabetic foot ulcersThe American Journal of Surgery, 1998
- The Association Between Callus Formation, High Pressures and Neuropathy in Diabetic Foot UlcerationDiabetic Medicine, 1996
- Total Contact Casting for Diabetic Neuropathic UlcersPTJ: Physical Therapy & Rehabilitation Journal, 1996
- Pathways to Diabetic Limb Amputation: Basis for PreventionDiabetes Care, 1990