Lower limb complications of diabetes mellitus: a comprehensive review with clinicopathological insights from a dedicated high-risk diabetic foot multidisciplinary team

Abstract

Diabetic complications in the lower extremity are associated with significant morbidity and mortality, and impact heavily upon the public health system. Early and accurate recognition of these abnormalities is crucial, enabling the early initiation of treatments and thus avoiding or minimizing deformity, dysfunction and amputation. Following careful clinical assessment, radiological imaging is central to the diagnostic and follow-up process. We aim to provide a comprehensive review of diabetic lower limb complications designed to assist radiologists and to contribute to better outcomes for these patients.

The Prevalence of Avascular Necrosis in Adults With Sickle Cell Disease in King Fahad Hospital.

“…A relationship between presence of AVN and DM was detected in this study. In previous researches the relationship between diabetes and developing pedal and jaw osteonecrosis is already established [31]. In earlier study that investigated association of DM and jaw osteonecrosis, the prevalence of microvascular diseases like neuropathy, retinopathy and nephropathy was significantly higher in diabetics who had jaw necrosis than in the control group [32].…”

“…Very little was found in the literature on the question of association between diabetes and AVN of hips. The pathogenesis of AVN in DM is not completely clear, but it may be attributed to complex interactions between diabetic vasculopathy, neuropathy, structural deformity and disruptive immune system [31]. Further work is required to establish the viability of this relationship.…”

Diabetic foot prevention activities recommended by the doctor and carried out by patients treated at 2 reference hospitals

“…El podólogo desempeña un papel fundamental en el seguimiento de los pacientes con Pies de riesgo, así como la participación del cirujano vascular, endocrinólogo, y los especialistas en ortopedia (21,22) . La Organización Mundial de la Salud, mediante estudios realizados, concluyó que los problemas del pie en las personas con diabetes constituyen la causa más frecuente de hospitalización y absorben, aproximadamente, en promedio un tercio de los recursos sanitarios disponibles.…”

Clinical Characteristics, Treatment, and Prognosis of Diabetic Foot Disease in Macao and Beijing: A Retrospective Study

“…Histopathologically, DFU is characterized by ischemia, neuropathy, and infection [4]. Additionally, approximately 35% of all patients with DFU have concomitant peripheral arterial disease (PAD) [5]. PAD is usually clinically underdiagnosed, as less than 25% of all PAD cases experience notable symptoms such as intermittent claudication and rest pain [6]; nevertheless, it has been identified as an independent risk factor for DFU and amputation [7].…”