Abstract
The diabetic foot presents a complex interplay of neuropathic, macrovascular, and microvascular disease on an abnormal metabolic background, complicated by an increased susceptibility to mechanical, thermal, and chemical injury and decreased healing ability. The abnormalities of diabetes, once present, are not curable. But most severe foot abnormalities in the diabetic are due to neglect of injury and are mostly preventable. The physician must ensure that the diabetic patient learns the principles of good foot care. If time for teaching is limited, this task must be delegated to a podiatrist or a diabetes nurse educator in a diabetes day centre. It is the physician's responsibility to confirm foot care by personal inspection of the feet of all diabetic patients at every visit.
Keywords: diabetes, endocrinology, foot care, foot disorders, orthopedics
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Selected References
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- BELL E. T. Atherosclerotic gangrene of the lower extremities in diabetic and nondiabetic persons. Am J Clin Pathol. 1957 Jul;28(1):27–36. doi: 10.1093/ajcp/28.1.27. [DOI] [PubMed] [Google Scholar]
- Dallinger K. J., Jennings P. E., Toop M. J., Gyde O. H., Barnett A. H. Platelet aggregation and coagulation factors in insulin dependent diabetics with and without microangiopathy. Diabet Med. 1987 Jan-Feb;4(1):44–48. doi: 10.1111/j.1464-5491.1987.tb00827.x. [DOI] [PubMed] [Google Scholar]
- Davis J. L., Lewis S. B., Gerich J. E., Kaplan R. A., Schultz T. A., Wallin J. D. Peripheral diabetic neuropathy treated with amitriptyline and fluphenazine. JAMA. 1977 Nov 21;238(21):2291–2292. [PubMed] [Google Scholar]
- Edmonds M. E., Nicolaides K. H., Watkins P. J. Autonomic neuropathy and diabetic foot ulceration. Diabet Med. 1986 Jan;3(1):56–59. doi: 10.1111/j.1464-5491.1986.tb00708.x. [DOI] [PubMed] [Google Scholar]
- Foster A., Edmonds M. E., Das A. K., Watkins P. J. Corn cures can damage your feet: an important lesson for diabetic patients. Diabet Med. 1989 Dec;6(9):818–819. doi: 10.1111/j.1464-5491.1989.tb01286.x. [DOI] [PubMed] [Google Scholar]
- GOLDENBERG S., ALEX M., JOSHI R. A., BLUMENTHAL H. T. Nonatheromatous peripheral vascular disease of the lower extremity in diabetes mellitus. Diabetes. 1959 Jul-Aug;8(4):261–273. doi: 10.2337/diab.8.4.261. [DOI] [PubMed] [Google Scholar]
- Janka H. U., Standl E., Mehnert H. Peripheral vascular disease in diabetes mellitus and its relation to cardiovascular risk factors: screening with the doppler ultrasonic technique. Diabetes Care. 1980 Mar-Apr;3(2):207–213. doi: 10.2337/diacare.3.2.207. [DOI] [PubMed] [Google Scholar]
- Masson E. A., Hay E. M., Stockley I., Veves A., Betts R. P., Boulton A. J. Abnormal foot pressures alone may not cause ulceration. Diabet Med. 1989 Jul;6(5):426–428. doi: 10.1111/j.1464-5491.1989.tb01198.x. [DOI] [PubMed] [Google Scholar]
- Sagel J., Colwell J. A., Crook L., Laimins M. Increased platelet aggregation in early diabetus mellitus. Ann Intern Med. 1975 Jun;82(6):733–738. doi: 10.7326/0003-4819-82-6-733. [DOI] [PubMed] [Google Scholar]
- Szirtes M. Platelet aggregation in diabetes mellitus. Adv Cardiol. 1970;4:179–186. doi: 10.1159/000387615. [DOI] [PubMed] [Google Scholar]
- Wheat L. J., Allen S. D., Henry M., Kernek C. B., Siders J. A., Kuebler T., Fineberg N., Norton J. Diabetic foot infections. Bacteriologic analysis. Arch Intern Med. 1986 Oct;146(10):1935–1940. [PubMed] [Google Scholar]