Foot disorders in diabetics. Source of serious morbidity

In the diabetic patient, the foot is particularly vulnerable to disorders resulting from vascular insufficiency, neuropathy, and infection. Without proper treatment, these disorders can lead to serious disability or amputation. Hyperglycemia, smoking, hypertension, and obesity contribute to the development of foot lesions. Early recognition of pedal lesions allows institution of measures (eg, special shoes, fitted inserts) that reduce risks of serious disorders. Patient education regarding foot care also plays an important role in prevention and management of disease. Aggressive treatment of infection and local care of lesions prevent extension of disease to adjacent areas. In cases of established infection or occlusive vascular disease amenable to bypass procedures, surgical intervention is frequently necessary. When amputation is required, rehabilitation professionals can assist the physician in patient education regarding personal care and readjustment.