Preventing and treating foot complications associated with diabetes mellitus
- 18 August 2015
- journal article
- review article
- Published by Springer Science and Business Media LLC in Nature Reviews Endocrinology
- Vol. 11 (10), 606-616
- https://doi.org/10.1038/nrendo.2015.130
Abstract
Diabetes mellitus is associated with a series of macrovascular and microvascular changes that can manifest as a wide range of complications. Foot ulcerations affect ∼ 2–4% of patients with diabetes mellitus. Risk factors for foot lesions include peripheral and autonomic neuropathy, vascular disease and previous foot ulceration, as well as other microvascular complications, such as retinopathy and end-stage renal disease. Ulceration is the result of a combination of components that together lead to tissue breakdown. The most frequently occurring causal pathways to the development of foot ulcers include peripheral neuropathy and vascular disease, foot deformity or trauma. Peripheral vascular disease is often not diagnosed in patients with diabetes mellitus until tissue loss is evident, usually in the form of a nonhealing ulcer. Identification of patients with diabetes mellitus who are at high risk of ulceration is important and can be achieved via annual foot screening with subsequent multidisciplinary foot-care interventions. Understanding the factors that place patients with diabetes mellitus at high risk of ulceration, together with an appreciation of the links between different aspects of the disease process, is essential to the prevention and management of diabetic foot complications.Keywords
This publication has 102 references indexed in Scilit:
- The Ipswich Touch TestDiabetes Care, 2011
- Evaluation and Optimization of Therapeutic Footwear for Neuropathic Diabetic Foot Patients Using In-Shoe Plantar Pressure AnalysisDiabetes Care, 2011
- Changes in the Incidence of Lower Extremity Amputations in Individuals With and Without Diabetes in England Between 2004 and 2008Diabetes Care, 2010
- Impact of Chronic Kidney Disease on Survival After Amputation in Individuals With DiabetesDiabetes Care, 2010
- Dialysis Treatment Is an Independent Risk Factor for Foot Ulceration in Patients With Diabetes and Stage 4 or 5 Chronic Kidney DiseaseDiabetes Care, 2010
- High Levels of Foot Ulceration and Amputation Risk in a Multiracial Cohort of Diabetic Patients on Dialysis TherapyDiabetes Care, 2010
- Comprehensive Foot Examination and Risk AssessmentDiabetes Care, 2008
- Duloxetine for painful diabetic neuropathy and fibromyalgia pain: systematic review of randomised trialsBMC Neurology, 2008
- Efficacy, Safety, and Tolerability of Pregabalin Treatment for Painful Diabetic Peripheral NeuropathyDiabetes Care, 2008
- Duplex ultrasonography, magnetic resonance angiography, and computed tomography angiography for diagnosis and assessment of symptomatic, lower limb peripheral arterial disease: systematic reviewBMJ, 2007