Diabetic foot is one of the most significant and devastating complications of diabetes, and is defined as a foot affected by ulceration that is associated with neuropathy and/or peripheral arterial disease of the lower limb in a patient with diabetes. The prevalence of diabetic foot ulceration in the diabetic population is 4–10%; the condition is more frequent in older patients. It is estimated that about 5% of all patients with diabetes present with a history of foot ulceration, while the lifetime risk of diabetic patients developing this complication is 15%

The majority (60–80%) of foot ulcers will heal, while 10–15% of them will remain active, and 5–24% of them will finally lead to limb amputation within a period of 6–18 months after the first evaluation.

Causes

The most significant risk factors for foot ulceration are:

• diabetic neuropathy,
• peripheral arterial disease,
• consequent traumas of the foot in diabetic patient.

Other risk factors

For foot ulceration include a previous history of foot ulceration or amputation, visual impairment, diabetic nephropathy, poor glycemic control, and cigarette smoking. Some studies have shown that foot ulceration is more common in men with diabetes than in women.

Social factors, such as low socioeconomic status, poor access to healthcare services, and poor education are also proven to be related to more frequent foot ulceration.

Treatment

The gold standard for diabetic foot ulcer treatment includes debridement of the wound, management of any infection, revascularization procedures when indicated, and off-loading of the ulcer. Other methods have also been suggested to be beneficial as add-on therapies, such as hyperbaric oxygen therapy, use of advanced wound care products, and negative-pressure wound therapy (NPWT).

• Debridement
• Off-loading
• Dressings
• Growth Factors
• Hyperbaric Oxygen

Caring for the feet

• Check feet every day.
• Individuals may have serious foot problems, but feel no pain.
• Check feet for cuts, sores, red spots, swelling, and infected toenails.
• Make checking feet a part of your every day routine.
• Wash feet every day
• Wash feet in warm, not hot water. Do not soak because skin will get dry.
• Dry feet well. Be sure to dry between the toes.
• Keep the skin soft and smooth
• Rub a thin coat of skin lotion or cream.
• Do not put lotion or cream between toes

Preventing foot problems

• Protect the feet
• Wear shoes and socks at all times.
• Choose clean, lightly padded socks that fit well. Socks that have no seams are best
• Check the insides of shoes before putting them on to be sure the lining is smooth and that there are no objects in them.
• Appropriate shoes
• Pointed toes or high heels put too much pressure on the toes.
• Shoes also need to be deep and wide enough to prevent rubbing.
• Protect your feet from hot and cold.
• Keep your feet away from radiators and open fires.
• Do not use hot water bottles on feet.
• Lined boots are good in winter to keep your feet warm and socks at night
• Remember to use sunscreen on the top of your feet if outside.
• Keep the blood flowing to the feet.
• Keep feet up when sitting.
• Exercises for the feet
• Wiggle toes for 5 minutes, 2 or 3 times a day
• Move ankles up and down and in and out.
• Don't Cross legs
• Don't smoke. Smoking reduces blood flow to feet.
• Wear tight socks, elastic or rubber bands, or garters around your legs.
• Control Blood glucose, blood pressure and cholesterol.