Review: The varied attractions of the diabetic foot

Abstract

V arious advances have been seen in the management of the diabetic foot. In some areas the rate of diabetes-related major amputations is declining. Duloxetine, pregabalin, venlafaxine and oxycodone are all well proven to help alleviate the pain of diabetic neuropathy. Negative pressure wound therapy has been shown to accelerate the healing of foot ulcers. New antibiotic policies designed to reduce Clostridium difficile and methicillin-resistant Staphylococcus aureus (MRSA) infections focus on narrow spectrum short duration antibiotics, and 80% of osteomyelitis can be successfully treated without surgery. Foot screening identifies patients who will ulcerate, with high-risk patients being up to 83 times more likely to ulcerate than low-risk patients. The 'holiday foot' and distal peripheral vascular disease remain as major risk factors for foot ulcer development and non-healing. The diabetic foot provides many interesting and varied challenges for the interested clinician. Br J Diabetes Vasc Dis 2009;9:155-159

Diabetic foot disease - new thoughts on prevention and treatment

“…Where a foot ulcer is present, an absent 'probe-to-bone test' makes osteomyelitis unlikely although only 50% with a positive test have osteomyelitis. 5 In this issue we have two interesting papers looking at different aspects of management of diabetic foot disease. The 6 The second by Tsourdi et al describes the successful management of a deep persistent diabetic foot ulcer by skin transplantation.…”

“…4 In a recent issue of this journal an extensive review of diabetic foot disease was presented. 5 Advances in foot ulcer management, wound healing with negative pressure therapy, antibiotics policies designed to reduce Clostridium difficile and MRSA infections were discussed. Information obtained from clinical examination for neuropathic abnormalities (e.g.…”

The Etiopathogenesis of the Diabetic Foot: An Unrelenting Epidemic

“…The major underlying causes are peripheral neuropathy (PN) and ischemia resulting from peripheral vascular disease (PVD). [5][6][7] The signs and symptoms of either ischemia or neuropathy may predominate, but the clinical picture is usually the result of complications arising from a combination of both.…”

A retrospective Evaluation of Antibacterials Used in the Management of Diabetics in a Tertiary Hospital in South-western Nigeria

“…Antibacterial drugs are recommended for the treatment of infections associated with diabetes [6,7]. One important challenge for physicians involved in the care of diabetics is the choice of appropriate antibacterial agents.…”