Understanding diabetic foot disease :Current status

Diabetic foot disease is a common and devastating 

complication of diabetes mellitus. 

Diabetic foot ulceration has an annual incidence of 2.2%, 

while the lifetime risk of developing foot ulceration among people with diabetes reaches up to 34% (1).

 Unfortunately, even after successful wound healing, 

the recurrence rates of diabetic foot ulcers (DFU) reach up to 40%

 within a year and it has been suggested to consider epithelialized 

DFU as being in remission rather than being healed (1).

 It is estimated that DFU, usually in association with infection or ischemia, precede around 75-85% of all diabetes-related lower limb amputations and remain the worldwide leading factor for non-traumatic lower extremity amputations (2).

 

Moreover, DFU severity seems to be a more significant predictor of subsequent mortality than coronary arterial disease, stroke or peripheral arterial disease (3) 

and foot ulceration is associated with a 5-year survival of 50 to 60% after presentation (4).

Diabetic foot ulcers are commonly caused by minor or repetitive trauma on an area of the foot in a person with peripheral neuropathy and/or peripheral arterial disease (1). 

Foot deformities, previous history of DFU or amputation, Charcot osteoarthropathy and reduced joint mobility leading to altered biomechanical loading are other major risk factors of foot ulceration (1).

 Nevertheless, impaired wound healing is considered the main factor the leads to the development of chronic diabetic wounds (5)

. The pathophysiology of diabetic wound healing is complex, multifaceted, and not completely understood so far. 

Moreover, more than half of DFU become infected, which in turn further slows wound healing and increases the risk of foot amputation (1)

Ref

Editorial Front Endocrinol (Lausanne). 2021 Sep 16;12:753181. doi: 10.3389/fendo.2021.753181

Editorial: Understanding Diabetic Foot Disease: Current Status and Emerging Treatment Approaches

Nikolaos Tentolouris 1,*, Michael E Edmonds 2, Edward B Jude 3, Prashanth R J Vas 2, Chris A Manu 2, Anastasios Tentolouris 1, Ioanna Eleftheriadou 1