Foot complications in patients with diabetes

Foot complications are a common cause of hospital admission of patients with diabetes and a frequent cause of amputation. Neuropathy and arterial disease make the foot particularly vulnerable, but infection is often the final presenting complication. Recognition of the patient at risk may prevent the development of foot complications initially, but if they occur rapid treatment is required to prevent limb loss. The infected foot in a patient with diabetes is a surgical emergency. In addition to antibiotics, debridement and surgical drainage of infection should be considered within the first 24 hours. Once the foot is made safe revascularization should be undertaken in those with significant arterial disease. Adoption of a coordinated approach to managing diabetic foot complications has resulted in reduction in major amputation in some European countries.