Dermatológia pre prax 3-4/2007

DIABETIC FOOT SYNDROME – A SERIOUS COMPLICATION OF DIABETES MELLITUS

Syndrome of diabetic foot describes a destructive involvement of tissues of lower extremities in patients with diabetes mellitus distally from the ankle resulting in vast ulcerations, gangrene and in ultimate cases even a necessity of amputation. It is a serious medical and social problem and one of the most expensive complications of diabetes mellitus. The treatment of diabetic foot syndrome requires longterm hospitalization and rehabilitation, patients frequently require home care and social services. The involvement of lower extremities is 17–50 times more frequent in diabetic patients in comparison with non-diabetic patients. Syndrome of diabetic foot develops during life in 15–25 % of diabetics, gangrene develops in 4–10 % of diabetics, amputation of lower extremities is necessary in 0.5–1 % diabetics (that is 30times more frequent than in non-diabetics) (8). It is sad that 15–19 % of diabetes mellitus is diagnosed only in patients with serious complications leading to amputation of an extremity. The care of patients with diabetic foot syndrome is multidisciplinary with involvement of several specialties (primary care physicians, dermatologists, internists-diabetologists, internits-angiologists, interventional radiologist, surgeons, and orthopedic surgeons), the most attention is paid however to prevention. Thoroughly applied preventive measures and timely adequate care can significantly lower the percentage of complications including the risk of extremity amputations.

Keywords: diabetic foot syndrome, diabetic neuropathy, diabetic angiopathy, limited joint mobility, prevention