Modern management of diabetic foot complications

Abstract

Diabetes mellitus comprises a heterogeneous group of metabolic abnormalities, characterized by chronic hyperglycemia, resulting from a deficiency in insulin secretion, a deficiency in action, or from both situations. In its evolution, diabetes can lead to acute or chronic complications, which can be avoided or whose progression can be slowed by optimal glycemic control, provided by the effective treatment, diet, physical activity and glycemic monitoring. One of the most common complications of diabetes is diabetic neuropathy which, in combination or not with peripheral arterial disease, may result in leg changes (ulcers, gangrene, amputations), changes that are known under the heading of diabetic foot. The risk of developing leg ulcer is 25% in the life of a patient with type 1 or 2 diabetes, and amputations of varying degrees may sometimes be necessary. These can, however, be prevented by active screening characterized by the neurological examination for neuropathic signs, and the vascular examination to highlight the presence of peripheral arterial disease. Therefore, in order to prevent the appearance of leg ulcers and to reduce the morbidity associated with it, it is important to diagnose and manage risk factors.

Keywords

• diabetic foot
• complications
• ulcer
• risk factors
• modern management
• amputation