Preventing and treating foot complications associated with diabetes mellitus

Abstract

Diabetes mellitus is associated with a series of macrovascular and microvascular changes that can manifest as a wide range of complications. Foot ulcerations affect ∼2-4% of patients with diabetes mellitus. Risk factors for foot lesions include peripheral and autonomic neuropathy, vascular disease and previous foot ulceration, as well as other microvascular complications, such as retinopathy and end-stage renal disease. Ulceration is the result of a combination of components that together lead to tissue breakdown. The most frequently occurring causal pathways to the development of foot ulcers include peripheral neuropathy and vascular disease, foot deformity or trauma. Peripheral vascular disease is often not diagnosed in patients with diabetes mellitus until tissue loss is evident, usually in the form of a nonhealing ulcer. Identification of patients with diabetes mellitus who are at high risk of ulceration is important and can be achieved via annual foot screening with subsequent multidisciplinary foot-care interventions. Understanding the factors that place patients with diabetes mellitus at high risk of ulceration, together with an appreciation of the links between different aspects of the disease process, is essential to the prevention and management of diabetic foot complications.

Effect of Thymoquinone on Wound Healing in Alloxan-Induced Diabetic Rats

“…Ulceration is as a result of collective tissue breakdown manifested by impaired healing [4,5]. This is primarily associated with a series of macrovascular and microvascular alteration that leads to many systemic complications [4,6]. These systemic complications will result in delayed wound healing that may eventually lead to limb amputation [4,7].…”

“…This is primarily associated with a series of macrovascular and microvascular alteration that leads to many systemic complications [4,6]. These systemic complications will result in delayed wound healing that may eventually lead to limb amputation [4,7]. Nontraumatic lower limb amputation is one of the worst complications of diabetes.…”

“…Chronic non-healing ulceration is commonly associated with diabetes mellitus affecting approximately 2-4% of patients [2][3][4]. Ulceration is as a result of collective tissue breakdown manifested by impaired healing [4,5].…”

“…Ulceration is as a result of collective tissue breakdown manifested by impaired healing [4,5]. This is primarily associated with a series of macrovascular and microvascular alteration that leads to many systemic complications [4,6].…”

Barriers and enablers to proper diabetic foot care amongst community dwellers in an Asian population: a qualitative study

“…However, not all elderly patients or individuals with sedentary lifestyles sustain diabetic foot conditions. Studies have shown that proper diabetic control and proper foot care are vital for the overall prevention of diabetic foot conditions such as neuropathic ulcers, Charcot's arthropathy and lower limb infections (such as cellulitis, osteomyelitis and septic arthritis) (4)(5)(6)(7)(8). Improper prevention of diabetic foot conditions can result in significant morbidity, decreased function and quality of life (9).…”