A Comprehensive Approach to Sidestep Diabetic Foot Problems

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Abstract
Diabetic foot problems remain as one of the major challenges associated with diabetes management. Problems associated with the diabetic foot are responsible for 20% of all hospitalized diabetics. The diabetic patient has a 15-fold higher risk for gangrene and diabetics constitute 50% of non-traumatic major lower limb amputations. Risk factors that predispose to the development of diabetic foot problems have been well defined. Diabetic neuropathy is the dominant risk and is associated with the development of foot trauma, ulceration, infection, and potential subsequent gangrene and amputation. Additional major risk factors include vasculopathy, foot deformity, and a previous history of ulceration-amputation. Timely identification of risk factors and corrective intervention have a major impact in the prevention of end-stage complications. Furthermore, an aggressive inter-disciplinary approach to advanced complications has a positive impact on both limb salvage and life preservation. Successful comprehensive foot care programs allocate significant resources to patient education. Patients must be provided with guidelines for daily foot care and need continuous monitoring to document compliance. Diabetic foot risk stratification facilitates a focused approach to individual risk and optimizes the educational input from the foot care team experts. The physician should, on a routine basis, examine the diabetic foot; this conveys the importance of self-inspection to the patient. A heightened awareness by physicians and patients regarding comprehensive foot care can achieve impressive preventative outcomes and timely recognition and successful intervention when complications occur. (C) Lippincott-Raven Publishers.

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