Diabetic Foot Care

Excerpt

Diabetes mellitus is a metabolic disorder characterized by chronic hyperglycemia. About 589 million adults aged 20 to 79 years are living with diabetes globally as of 2025, and diabetes-related deaths are estimated at approximately 3 to 4 million annually. (Source: International Diabetes Foundation, 2025) Individuals with diabetes are at increased risk of pedal ulceration due to microvascular, neuropathic, and biomechanical alterations in the foot. Neuropathy reduces pedal sensation, predisposing the foot to pressure- and trauma-related injuries. Microvascular dysfunction impairs blood flow to the lower extremities, delaying wound healing.

Hemoglobin A1c (HbA1c) indicates mean blood glucose over 2 to 3 months. Both the American Diabetes Association (ADA) and the International Expert Committee recommend an HbA1c of 6.5% or greater for diabetes diagnosis. Each 1% increase in HbA1c increases peripheral vascular disease risk by 25% to 28%.

Patients with diabetes face an elevated risk of lower extremity amputation, increased healthcare costs, and reduced quality of life. In a systematic review of nontraumatic amputations among patients with diabetes and peripheral vascular disease, the 5-year mortality rate after below-the-knee amputation was 40% to 82%, and 40% to 90% following above-the-knee amputation. Many complications are preventable through annual foot examination and routine patient-performed foot care. This activity delves into the anatomy, indications, equipment, personnel, preparation, technique, complications, and clinical significance of diabetic foot care.