Diabetic foot

Diabetes is one of the causes of mortality worldwide and it is a leading cause of morbidity. 2–10% persons with diabetes may develop lower extremity ulcer during the course of disease and the foot ulceration is the precursor to approximately 85% of lower extremity of amputations. Diabetic foot ulcers have multiple risk factors, diabetic peripheral neuropathy plays central role. Careful history and neurological, vascular and musculoskeletal system examination is important. Classify the ulcer according to Modified Wagner Classification System or University of Texas system. Few bedside test like ankle brachial index, vibration perception threshold, pedopodgraph and hot and cold sensidometer are important tools for the risk categorization of lower limb. Management is according to the risk category. The infection in diabetic foot is usually polymicrobial and the treatment is based on culture and sensitivity and empirical antimicrobial therapy is according to the audit of the culture and sensitivity of the diabetic foot wound for previous year. Patient education is an effective tool for the prevention of diabetic foot ulcer and further limb loss.