Diabetic Foot Disorders

People with diabetes are prone to ulceration of the feet. This is because of the effects that diabetes has on the body:

1. Diabetes damages the sensory nerves as well as the autonomic nerves (nerves to the sweat glands) – causing loss of sensation, inability to detect pain sensation and dry skin which is prone to cracking and ulceration.
2. Diabetes can reduces the blood supply to the foot by causing narrowing and blockages in the arteries. This can make it difficult for wounds to heal.
3. Diabetes increases the susceptibility to infection
4. Diabetes causes deformity of the feet which can lead to pressure points on the foot which in turn can lead to callus, skin breakdown and ulceration.

15% of diabetics will get a foot ulcer. Diabetes complications cause 50-60% of all leg amputations.

Assessment

Patients with diabetes and ulceration are initially assessed with a history and examination, and may need investigations such as:

• X-rays
• Ultrasounds
• CT Scans
• MRI Scans
• Nuclear Medicine Scans
• Catheter Angiography

Treatment

Treatment varies depending on the severity of the ulcer, the blood supply to the foot and the level of infection present. Early review is always best for a diabetic foot ulcer.