[Obliterating diabetic microangiopathy of the diabetic foot--reality or false conclusion?]

Occlusive diabetic microangiopathy like diabetic retinopathy and diabetic nephropathy has not been confirmed unequivocally in the diabetic foot. Non-occlusive disturbances, such as impaired vasomotion due to diabetic neuropathy, have been documented in the diabetic foot. Their clinical relevance, however, remains to be established. Recent reports have shown that the histopathological picture of diabetic gangrene is associated with septic vasculitis rather than diabetic microangiopathy. The assumption that diabetic gangrene in the presence of palpable foot pulses is due to occlusive microangiopathy and thus can be treated only by major amputation, appears to be unfounded.