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Some risk factors for developing diabetic foot infections include history of repeated foot ulcers, foot ulcers lasting for longer than 30 days, poor control over blood glucose levels, peripheral neuropathy, renal impairment, peripheral artery disease, injury or trauma to foot, walking barefoot frequently, and history of amputation in lower limbs.
Foot of an 80-year old individual with type 2 diabetes and heart failure. The second toe has a large ischaemic ulcer. The first toe has a small one. The prevalence of arterial insufficiency ulcers among people with Diabetes is high due to decreased blood flow caused by the thinning of arteries and the lack of sensation due to diabetic neuropathy.
Diabetic foot ulcer is a breakdown of the skin and sometimes deeper tissues of the foot that leads to sore formation. It is thought to occur due to abnormal pressure or mechanical stress chronically applied to the foot, usually with concomitant predisposing conditions such as peripheral sensory neuropathy, peripheral motor neuropathy, autonomic neuropathy or peripheral arterial disease. [1]
Diabetic foot conditions can be acute or chronic complications of diabetes. [1] Presence of several characteristic diabetic foot pathologies such as infection, diabetic foot ulcer and neuropathic osteoarthropathy is called diabetic foot syndrome. The resulting bone deformity is known as Charcot foot.
Critical limb ischemia is diagnosed by the presence of ischemic rest pain, and an ulcers that will not heal or gangrene due to insufficient blood flow. [3] Insufficient blood flow may be confirmed by ankle-brachial index (ABI), ankle pressure, toe-brachial index (TBI), toe systolic pressure, transcutaneous oxygen measurement (TcpO2 ), or skin perfusion pressure (SPP).
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Grade 2: deep ulcer with exposed tendon or bone, gangrene limited to toes; Grade 3: extensive, full-thickness ulcer; gangrene extending to the forefoot or midfoot; Ischemia is graded 0 through 3 based on ABI, ankle systolic pressure, and toe pressure. [66] Grade 0: ABI ≥0.80, ankle systolic pressure ≥100 mm Hg, toe pressure ≥60 mm Hg
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