Diabetic Foot Disease

Question 1

what is diabetic foot disease?

Answer 1

disease of the foot in a person with current or previously diagnosed diabetes mellitus, including one or more of the following:

• peripheral neuropathy
• PAD
• ulcer
• infection (e.g. osteomyelitis)
• neuro-osteoarthropathy
• gangrene
• amputation

Question 2

what are the symptoms of diabetic foot disease?

Answer 2

• neuropathic (e.g. numbness, tingling, weakness, deformity)
• ischaemic (e.g. coldness, pallor, delayed healing, shiny, hairless skin, absent/weak pulses, pain)
• infective (e.g. erythema, pus, fever, cellulitis, ulcers, necrosis)

Question 3

what are the investigations for diabetic foot disease?

Answer 3

• clinical
• FBC
• CRP/ESR
• U&Es
• HbA1C
• culture
• ankle-brachial index (e.g. ABI)
• XR foot
• MR/CT angiography

Question 4

what is the acute management of diabetic foot disease?

Answer 4

• debridement
• dressing
• offloading footwear/devices
• ? antibiotic
• ? surgical drainage +/- debridement

Question 5

what is the ongoing management of diabetic foot disease?

Answer 5

• optimisation of DM
• offloading footwear/devices
• ? offloading surgery
• ? surgical bypass +/- endovascular intervention
• ? amputation