Presence of several characteristic diabetic foot pathologies such as infection, diabetic foot ulcer and neuropathic osteoarthropathy is called diabetic foot syndrome. This means that minor injuries may remain undiscovered for a long while. People with diabetes are also at risk of developing a diabetic foot ulcer. Around half diabetic foot examination pdf patients with a diabetic foot ulcer have co-existing PAD.
Where wounds take a long time to heal, infection may set in and lower limb amputation may be necessary. Foot infection is the most common cause of non-traumatic amputation in people with diabetes.
Patients would be taught routinely to inspect their feet for hyperkeratosis, fungal infection, skin lesions and foot deformities. Control of footwear is also important as repeated trauma from tight shoes can be a triggering factor. There is however only limited evidence that patient education has a long-term impact as a preventative measure. Of all methods proposed to prevent diabetic foot ulcers, only foot temperature-guided avoidance therapy was found beneficial in RCTs” according to a meta-analysis.
The objective of antibiotic therapy is to stop the infection and ensure it does not spread. It is unclear whether any particular antibiotic is better than any other for curing infection or avoiding amputation. One trial suggested that ertapenem with or without vancomycin is more effective than tigecycline for resolving DFIs.
It is also generally unclear whether different antibiotics are associated with more or fewer adverse effects. Preventing Foot Ulcers in Patients With Diabetes”.
Guidance on the diagnosis, prognosis and management of peripheral artery disease in patients with foot ulcers in diabetes”. Systemic antibiotics for treating diabetic foot infections”. Patient education for preventing diabetic foot ulceration”.