diabetic foot

Last edited 01/2020 and last reviewed 07/2021

Foot complications are common in people with diabetes

• estimated that 10% of people with diabetes will have a diabetic foot ulcer at some point in their lives
  • a foot ulcer can be defined as a localised injury to the skin and/or underlying tissue, below the ankle, in a person with diabetes

A "diabetic foot" may be the result of:

• peripheral neuropathy
• peripheral ischaemia
• often there is a mixed aetiology

The atherosclerotic foot is pale, cold and pulseless.

The neuropathic foot is red, warm and has palpable pulses.

Diabetes is the most common cause of non-traumatic limb amputation, with diabetic foot ulcers preceding more than 80% of amputations in people with diabetes

• after a first amputation, people with diabetes are twice as likely to have a subsequent amputation as people without diabetes
• mortality rates after diabetic foot ulceration and amputation are high, with up to 70% of people dying within 5 years of having an amputation and around 50% dying within 5 years of developing a diabetic foot ulcer
  • high mortality rate is believed to be associated with cardiovascular disease, and emphasises the importance of good diabetic and cardiovascular risk management
• although people of South Asian, African and African-Caribbean family origin are more at risk of diabetes, there is no evidence that the prevalence of diabetic foot ulceration and amputation is higher in these subgroups than in the general population of people with diabetes in the UK

Reference:

• NICE (August 2015). Diabetic foot problems: prevention and management