[Diabetic foot: from diagnosis to therapy]

Area of Science:

• Endocrinology and Vascular Surgery
• Diabetology
• Podiatry

Context:

• Diabetes mellitus affects 4% of Italians and 120 million worldwide, with a 15% lifetime risk of foot wounds.
• Diabetic foot is a leading cause of non-accidental amputation in industrialized nations, with a 15x higher risk for diabetics.
• Pathogenesis involves vasculopathy, neuropathy, and infection, impacting long-term diabetes mellitus patients significantly.

Purpose:

• To outline the pathogenesis, diagnostics, and therapeutic challenges of diabetic foot.
• To emphasize the critical role of early detection and intervention for diabetic foot complications.
• To highlight the necessity of a collaborative, multidisciplinary approach in managing diabetic foot.

Summary:

• Diabetic foot development is driven by vasculopathy and neuropathy, with infection as a common factor. Arteriopathy and neuropathy prevalence increase with disease duration.
• Diagnostic tools include objective examination, Doppler ultrasonography, arteriography, EMG, and autonomic function tests.
• Osteomyelitis is a severe complication often requiring surgical intervention. Effective therapy necessitates a synergistic team effort.

Impact:

• Improved understanding of diabetic foot etiology and progression.
• Enhanced diagnostic strategies for early identification of at-risk patients.
• Promotes a holistic, team-based approach to diabetic foot care, potentially reducing amputation rates.