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Publication

The pathway to foot ulceration in diabetes.

Abstract

It should now be possible to achieve a reduction in the incidence of foot ulceration and amputations as knowledge about pathways that result in both these events increases. However, despite the universal use of patient education and the hope of reducing the incidence of ulcers in high-risk patients, there are no appropriately designed large, randomized controlled trials actually confirming that education works. It has been recognized for some years that education as part of a multidisciplinary approach to care of the diabetic foot can help to reduce the incidence of amputations in certain settings. Ultimately, however, a reduction in neuropathic foot problems will only be achieved if we remember that the patients with neuropathic feet have lost their prime warning signal—pain—that ordinarily brings patients to their doctor. Very little training is offered to health care professionals as to how to deal with such patients. Much can be learned about the management of such patients from the treatment of individuals with leprosy: if we are to succeed, we must realize that with loss of pain there is also diminished motivation in the healing of and prevention of injury.

More information

Type
Journal Article
Author
Boulton AJ M
Year of Publication
2013
Journal
The Medical clinics of North America
Volume
97
Issue
5
Number of Pages
775-90
Language
eng
ISSN Number
1557-9859
DOI
10.1016/j.mcna.2013.03.007
Alternate Journal
Med. Clin. North Am.
Publication Language
eng