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Chapter-032 Foot Complications in Diabetes

BOOK TITLE: ESI Manual of Clinical Endocrinology

Author
1. Ahmad Jamal
2. Zubair Mohammad
ISBN
9789351526476
DOI
10.5005/jp/books/12535_41
Edition
2/e
Publishing Year
2015
Pages
16
Author Affiliations
1. Centre for Diabetes and Endocrinology, Faculty of Medicine, Jawaharlal Nehru, Medical College Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India, Thomas Jefferson University Hospital, Rothman Institute Philadelphia, Pennsylvania, USA, Jawaharlal Nehru Medical College Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India, Rajiv Gandhi Centre for Diabetes and Endocrinology; Aligarh Muslim University, Aligarh (UP), India, Rajiv Gandhi Centre for Diabetes and Endocrinology, Jawaharlal Nehru Medical College, Aligarh, Uttar Pradesh, India, Diabetes and Endocrinology Super Speciality Centre, Aligarh, Uttar Pradesh, India, Rajiv Gandhi Centre for Diabetes and Endocrinology, Jawaharlal Nehru Medical College Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India, Rajiv Gandhi Centre for Diabetes and Endocrinology; JN Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
2. Rajiv Gandhi Centre for Diabetes and Endocrinology, JN Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
Chapter keywords
Peripheral neuropathy, charcot neuropathy, osteomyelitis, biofilm, ankle brachial index, procalcitonin, negative pressure wound therapy

Abstract

Diabetic foot ulcers (DFUs) are one of the most common and serious complications of diabetes which results in increasing morbidity and normality. Vascular insufficiency, peripheral neuropathy, soft tissue and bone deformity are several risk factors responsible for the development of foot ulceration. The first sign of infection in diabetic foot ulcers is loss of blood glucose control or a flu-like syndrome and these infections are usually polymicrobial and include aerobic gram positive cocci (Staphylococcus aureus), gram negative bacilli (Escherichia coli, Klebsiella species, and Proteus species), and anaerobes (Bacteroides sp. and Peptostreptococcus sp.). Simple neuropathic assessment ideally includes: pin prick sensation, light touch, vibration, ankle reflexes and pressure sensation. Preventive strategies should include a multidisciplinary approach for both improved patient outcomes and short-and long-term cost effectiveness and patient education is essential. Instructions given on foot hygiene and shoes may help patient to avoid foot ulceration and infection. A multidisciplinary approach is effective protocol for treating superficial uncomplicated ulcers and limb-threatening infections are discussed in this chapter.

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