[Symptomatology and diagnosis of the diabetic foot]

In the diabetic foot, the vascular component was recently considered as the most important in its pathogenesis. The contribution of the neuropathy was under evaluated, most of the time. However, in the last few years, the neuropathic modifications rank first and the micro- and macro-angiopathies are considered more and more as complicating components. Along with sensory and motor neuropathies, the so-called neuropathic edema is an important symptom. This edema, hot most of the time, is caused by a paralysis of the sympathetic nerve fibres, causing an increased Arterio-venous "shunt", at the expense of the capillary nutritive blood circulation. Orthostasis components and he possible presence of venous insufficiency aggravate he edema. The influence of cardiac components must be excluded. Besides, the likelihood of a venous thrombosis is not increased in diabetic patients. A multi-disciplinary approach is advocated in the diabetic foot.