Diabetic Foot

 Diabetes mellitus is a highly prevalent disease globally and contributes to significant morbidity and mortality.

 As a consequence of multiple pathophysiologic changes which are associated with diabetes, these patients frequently suffer from foot-related disorders: infections, ulcerations, and gangrene. 

Approximately half of all amputations occur in diabetic individuals, usually as a complication of diabetic foot ulcer

The most frequent complications of the lower extremity were ulcerations and gangrene. 

Moreover, in our study, 35% of patients required surgical reintervention, and 27% suffered from complications, while 13% required ICU admission. 

However, diabetic foot lesions are preventable via simple interventions which pointedly reduce foot amputations.

 Early identification and the appropriate medical and surgical treatment of the complications associated with diabetic foot disease are important because they still remain common, complex and costly.

Introduction :

There are more than 463 million people with diabetes mellitus (DM) worldwide [1]. 

These patients are at risk of multiple diabetes-related complications. Specifically, foot problems cause serious morbidity and mortality in these patients. 

Diabetic patients frequently suffer from foot-related disorders such as gangrene, infection and ulcerations. 

DM is a significant risk factor for peripheral artery disease [2,3]. The International Diabetes Federation estimates that 9.1–26.1 million diabetic individuals will develop diabetic foot ulcers (DFUs) every year [4].

 Moreover, type 1 and type 2 diabetics have a lifetime risk of foot ulcers as high as 34 percent [4]. 

Epidemiological data indicate that diabetic patients have a risk of 2.5% per year to develop foot ulcers [5].

 As shown by a population-based cohort study, diabetic foot ulcers are associated with 5% mortality within the first 12 months and 42% percent mortality at 5 years after first occurrence [6].

In the United States, the treatment of the diabetic foot is responsible for approximately 30 percent of the total costs for diabetic patients’ care—an estimated U.S. $ 176 billion in healthcare costs [8]. 

Additionally, about 20% of patients have unhealed diabetic foot lesions at one year after their diagnosis [9],

 and the recurrence rate is approximately 40% at one year [4]. Diabetic foot amputations also carry significant stigma and impact the quality of life of DM patients [10].

Multiple risk factors contribute to the development of DFUs and other foot lesions such as gangrene and lower extremity infections: poor glycemic control; vascular disease; inadequate foot care; neuropathy and the subsequent loss of protective sensation; foot deformity; trauma; diabetes-related compromised immunity and infections [16].

Int J Environ Res Public Health. 2022 Dec 23;20(1):187. doi: 10.3390/ijerph20010187

Diabetic Foot Complications: A Retrospective Cohort Study

Bogdan Stancu 1,*, Tamás Ilyés 2, Marius Farcas 3, Horațiu Flaviu Coman 4, Bogdan Augustin Chiș 5, Octavian Aurel Andercou 1

Editor: Omorogieva Ojo