Managing diabetic foot problems - A clinical perspective
Abstract
Diabetic foot problems are a major complication of diabetes, and have a significant impact on morbidity and mortality. Foot ulcer remains a major health concern in people with diabetes. Diabetic foot problems require good clinical care which includes effective bedside screening for neuropathy and vascular problems, both of which are contributing factors for the foot problems. Early, aggressive treatment including glycaemic control, right intervention, antibiotic therapy along with good foot care practices such as good foot hygiene and daily inspection, proper footwear which
minimises pressure, offloading and wound care management are all crucial in preventing and managing major foot related problems.
References
1) IDF DIABETS ATLAS, 6th edition, 2014 update assessed from:www.idf.org/diabetesatlas
2) National Institute for Health and Clinical Excellence. Diabetic foot problems: inpatient management of diabetic foot problems. Clinical guideline 119. London: NICE, 2011.
Available at: http://publications.nice.org.uk/diabetic-footproblems- cg119. Accessed Novem-ber 4th, 2015
3) Abetz L, Sutton M, Brady Let al. The diabetic foot ulcer scale: a quality of life instrument for use in clinical trials. PractDiab Int. 2002;19:167-75
4) Hinchcliffe RJ, Andros G, Apelqvist Jet al. A systematic review of the effectiveness of revascularisation of the ulcerated foot in patients with diabetes and peripheral arterial disease. Diabetes Metab Res Rev. 2012; 28(Suppl 1): 179- 217.
5) Pecoraro RE, Reiber GE, Burgess EM. Pathways to diabetic limb amp tation. Basis for prevention. Diabetes Care. 1990;13(5):513-21.
6) Wu S, Driver VR, Wrobel JS, et al. Foot ulcers in the diabetic patient, prevention and treatment. Vasc Health Risk Manag. 2007;3(1): 65–76
7) Reiber GE, Vileikyte L, Boyko EJ, et al. Causal pathways for incident lower-extremity ulcers in patients with diabetes from two settings. Diabetes Care.1999;22: 157–62.
8) Edmonds ME, Foster AVM. Diabetic foot ulcers. BMJ.2006;332:407–10
9) Gentile AT, Berman SS, Reinke KR, Demas CP, Ihnat DH, Hughes JDet al. A regional pedal ischemia scoring system for decision analysis in patients with heel ulceration. Am J Surg.1998;176(2):109-14.
10) Dutta P, Bhansali A, Mittal BR, Singh B, Masoodi SR. Instant 99mTc-ciprofloxacin scintigraphy for the diagnosis of osteomyelitis in the diabetic foot. Foot Ankle Int. 2006; 27(9):716- 22.
11) Kavitha KV, Tiwari S, Purandare VB, Khedkar S, Bhosale SS, Unnikrishnan AG. Choice of wound care in diabetic foot ulcer: A practical approach World J Diabetes. 2014;5(4): 546–556.
12) Bharath Ret al. A comparative study of zoledronic acid and once weekly Alendronate in the management of acute Charcot arthropathy of foot in patients with diabetes mellitus. Indian J Endocrinol Metab. 2013;17(1):110–116
13) Lipsky BA, Berendt AR, Cornia PB, Pile JC, Peters EJ, Armstrong DG, Deery HG et al. 2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections. Clin Infect Dis. 2012;54:e132–e173.
14) Roeckl-Wiedmann I, Bennett M, Kranke P. Systematic review of hyperbaric oxygen in the management of chronic wounds. Br J Surg.2005;92(1):24-32.
15) Venturi ML, Attinger CE, Mesbahi AN, Hess CL, Graw KS. Mechanisms and clinical applications of the vacuum-assisted closure (VAC) Device: a review. Am J Clin Dermatol. 2005;6:185–194.
16) Boulton AJ, Kirsner RS, Vileikyte L. Clinical practice. Neuropathic diabetic foot ulcers. N Engl J Med. 2004;351(1):48-55
2) National Institute for Health and Clinical Excellence. Diabetic foot problems: inpatient management of diabetic foot problems. Clinical guideline 119. London: NICE, 2011.
Available at: http://publications.nice.org.uk/diabetic-footproblems- cg119. Accessed Novem-ber 4th, 2015
3) Abetz L, Sutton M, Brady Let al. The diabetic foot ulcer scale: a quality of life instrument for use in clinical trials. PractDiab Int. 2002;19:167-75
4) Hinchcliffe RJ, Andros G, Apelqvist Jet al. A systematic review of the effectiveness of revascularisation of the ulcerated foot in patients with diabetes and peripheral arterial disease. Diabetes Metab Res Rev. 2012; 28(Suppl 1): 179- 217.
5) Pecoraro RE, Reiber GE, Burgess EM. Pathways to diabetic limb amp tation. Basis for prevention. Diabetes Care. 1990;13(5):513-21.
6) Wu S, Driver VR, Wrobel JS, et al. Foot ulcers in the diabetic patient, prevention and treatment. Vasc Health Risk Manag. 2007;3(1): 65–76
7) Reiber GE, Vileikyte L, Boyko EJ, et al. Causal pathways for incident lower-extremity ulcers in patients with diabetes from two settings. Diabetes Care.1999;22: 157–62.
8) Edmonds ME, Foster AVM. Diabetic foot ulcers. BMJ.2006;332:407–10
9) Gentile AT, Berman SS, Reinke KR, Demas CP, Ihnat DH, Hughes JDet al. A regional pedal ischemia scoring system for decision analysis in patients with heel ulceration. Am J Surg.1998;176(2):109-14.
10) Dutta P, Bhansali A, Mittal BR, Singh B, Masoodi SR. Instant 99mTc-ciprofloxacin scintigraphy for the diagnosis of osteomyelitis in the diabetic foot. Foot Ankle Int. 2006; 27(9):716- 22.
11) Kavitha KV, Tiwari S, Purandare VB, Khedkar S, Bhosale SS, Unnikrishnan AG. Choice of wound care in diabetic foot ulcer: A practical approach World J Diabetes. 2014;5(4): 546–556.
12) Bharath Ret al. A comparative study of zoledronic acid and once weekly Alendronate in the management of acute Charcot arthropathy of foot in patients with diabetes mellitus. Indian J Endocrinol Metab. 2013;17(1):110–116
13) Lipsky BA, Berendt AR, Cornia PB, Pile JC, Peters EJ, Armstrong DG, Deery HG et al. 2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections. Clin Infect Dis. 2012;54:e132–e173.
14) Roeckl-Wiedmann I, Bennett M, Kranke P. Systematic review of hyperbaric oxygen in the management of chronic wounds. Br J Surg.2005;92(1):24-32.
15) Venturi ML, Attinger CE, Mesbahi AN, Hess CL, Graw KS. Mechanisms and clinical applications of the vacuum-assisted closure (VAC) Device: a review. Am J Clin Dermatol. 2005;6:185–194.
16) Boulton AJ, Kirsner RS, Vileikyte L. Clinical practice. Neuropathic diabetic foot ulcers. N Engl J Med. 2004;351(1):48-55
Published
2019-08-07
How to Cite
Kavitha Kumar, A G Unnikrishnan. (2019). Managing diabetic foot problems - A clinical perspective. The Indian Practitioner, 68(11), 62-69. Retrieved from https://articles.theindianpractitioner.com/index.php/tip/article/view/537
Section
Review article
