Diabetic foot, according to the Spanish Society of Angiology and Vascular Surgery, is a situation that is reached after years of suffering from diabetes and basically consists of an alteration of the sensitivity of the foot which will facilitate the appearance of lesions, precisely because of this lack of pain control.
The patient cannot defend himself because of the lack of sensitivity to pain, which would warn of the damage, as when it hurts because of a chafing or blister due to a new shoe, and this lack of sensitivity to pain triggers the appearance of serious injuries of the foot.
That is to say that the alteration of the sensitivity and motility of the foot in a diabetic patient of years of evolution by itself, can injure the tissues of the diabetic foot without the existence of vascular lesion.
This neurological involvement occurs in 90% of patients with diabetes and should be evaluated to prevent injuries that can lead to limb amputation. In fact, diabetes is the most frequent cause of non-traumatic amputations of the lower extremity in Europe and the USA.
Causes of diabetic foot
The risk factors to prevent this serious injury and that can be modified are: peripheral vascular disease, neuropathy (affectation of the sensitivity and motility of the foot), foot deformities, high plantar pressure, calluses or smoking.
In diabetic patients with a low risk of foot disorders, an annual evaluation by an angiologist and vascular surgeon is recommended, in cases of moderate risk every 3-6 months and in high-risk patients every month.
Prevention of these lesions is the best way to avoid major amputation of the limb.
Assessment of the diabetic foot is done on an outpatient basis in the office and consists of a clinical examination and a Doppler examination to determine the ankle/brachial index.