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Foot problems are a common complication in people with diabetes,
and are the most frequent reason for hospitalisation in diabetic
patients [Frykberg et
al, 2000; Willoughby and Burroughs, 2001]. Risk factors
for foot ulceration include peripheral vascular disease, peripheral
neuropathy, the presence of callus and joint deformity. Diabetic
foot complications, particularly foot ulcers, are the most
common cause of preventable nontraumatic lower extremity amputation
[Armstrong and Lavery,
1998a].
Although not a primary endpoint of the UK Prospective Diabetes
Study (UKPDS), the progression of neuropathy was reduced by
intensive glycaemic control [UK
Prospective Diabetes Study Group, 1998]. Intensified diabetes
management should therefore be considered for people with
Type 2 diabetes to prevent the onset and progression of neuropathy.
Symptoms of diabetic foot disease are frequently unreliable
and asymptomatic foot disease is very common. Screening is
therefore essential to identify those at risk
[Williams and Airey, 2000].
Prevention is the most important aspect of treatment. Rigorous
foot care and the use of therapeutic footwear, or total contact
casts to immobilise the foot and offload the pressure on ulcers,
are key to the management of the diabetic foot.
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