Diabetic foot

Question 1

• Individuals with diabetic foot ulcers have a ? chance of mortality

Answer 1

• Individuals with diabetic foot ulcers have a 50%

chance of mortality in 5 years

Question 2

Is diabetic foot a microvascular or a macrovascular complication of diabetes?

Answer 2

microvascular complication

Question 3

Microvascular Effects of Diabetes

Answer 3

• Retinopathy, nephropathy, neuropathy
• Altered blood flow (angiopathy) – Ischemia – Leaky vessels
• Neuropathy
– Motor 
– Sensory
– Autonomic

Question 4

Vascular changes in Diabetes

Answer 4

A number of changes which lead to
• Reduced nutrient & oxygen delivery
• Reduced clearance of toxins
• Inappropriate leakage from blood vessels
• Inappropriate vascularisation of tissue

Question 5

How might Motor Neuropathy contribute to the pathogenesis of diabetic foot?

Answer 5

Weakness and wasting of foot muscles -> Foot deformities - > Gait Abnormalities -> Abnormal wear -> Ulceration

Question 6

How might Sensory Neuropathy contribute to the pathogenesis of diabetic foot?

Answer 6

Loss of pain sensation -> Unnoticed trauma -> Callus formation -> Necrosis & damage beneath callus ->
Ulceration

Question 7

How might Autonomic Neuropathy contribute to the pathogenesis of diabetic foot?

Answer 7

Decreased sweating, altered blood flow -> Dry & brittle skin -> Fissures/cracks -> Infection -> Ulceration ->