Diabetic Foot Disease

Skin & Subcutaneous Tissue


Clinicals - History

Fact Explanation
{"ops":[{"insert":"Introduction"},{"insert":"\n"}]}
{"ops":[{"insert":"Diabetic foot disease (DFD) refers to a range of syndromes due to peripheral neuropathy, peripheral arterial disease (PAD), and other pathologies that can lead to ulcers, osteomyelitis, and amputations of the foot."}]}
{"ops":[{"insert":"Distal neuropathy"},{"insert":"\n"}]}
{"ops":[{"insert":"Diabetes can lead to distal symmetrical polyneuropathy (DSPN) that typically involves the feet and progresses up the leg. It leads to tingling, numbness, stinging pain, dysesthesia, hyperalgesia, allodynia, and increases the risk of ulcers and deformity. Persistent hyperglycemia leads to metabolic changes in the blood vessel that supply the peripheral nerves with loss of nerve fibers. This is believed to be a result of disorders in glial cell activation, ion channel expression, and central pain mechanisms."}]}
{"ops":[{"insert":"Muscle weakness"},{"insert":"\n"}]}
{"ops":[{"insert":"Muscle weakness may present in the toe extensors and progress to involve both feet and hands, possibly leading to muscle wasting and deformity. This is due to progressive muscular denervation."}]}
{"ops":[{"insert":"Foot deformity"},{"insert":"\n"}]}
{"ops":[{"insert":"Patients may present with foot deformities such as hammertoes, flat foot, equinus or varus deformities, or others. This is due to abnormal walking dynamics and pressure distribution caused muscle wasting and atrophy."}]}
{"ops":[{"insert":"Loss of coordination"},{"insert":"\n"}]}
{"ops":[{"insert":"Patients may complain of loss of coordination or clumsiness of the feet. This is because peripheral neuropathy can lead to large fiber neuropathy with loss of vibration and proprioception sense."}]}
{"ops":[{"insert":"Peripheral arterial disease"},{"insert":"\n"}]}
{"ops":[{"insert":"PAD presents with intermittent claudication, gangrene, and increased risk of infection and amputation. This leads to cramping and aching pains in calf muscles, thighs, or buttocks that is aggravated by walking and alleviated by rest. This is due to ischemia."}]}
{"ops":[{"insert":"Ulcers"},{"insert":"\n"}]}
{"ops":[{"insert":"Patients with DFD can present with foot ulcers. These are due to neuropathy and ischemic factors."}]}
{"ops":[{"insert":"Introduction"},{"insert":"\n"}]}
{"ops":[{"insert":"Diabetic foot disease (DFD) refers to a range of syndromes due to peripheral neuropathy, peripheral arterial disease (PAD), and other pathologies that can lead to ulcers, osteomyelitis, and amputations of the foot."}]}
{"ops":[{"insert":"Distal neuropathy"},{"insert":"\n"}]}
{"ops":[{"insert":"Diabetes can lead to distal symmetrical polyneuropathy (DSPN) that typically involves the feet and progresses up the leg. It leads to tingling, numbness, stinging pain, dysesthesia, hyperalgesia, allodynia, and increases the risk of ulcers and deformity. Persistent hyperglycemia leads to metabolic changes in the blood vessel that supply the peripheral nerves with loss of nerve fibers. This is believed to be a result of disorders in glial cell activation, ion channel expression, and central pain mechanisms."}]}
{"ops":[{"insert":"Muscle weakness"},{"insert":"\n"}]}
{"ops":[{"insert":"Muscle weakness may present in the toe extensors and progress to involve both feet and hands, possibly leading to muscle wasting and deformity. This is due to progressive muscular denervation."}]}
{"ops":[{"insert":"Foot deformity"},{"insert":"\n"}]}
{"ops":[{"insert":"Patients may present with foot deformities such as hammertoes, flat foot, equinus or varus deformities, or others. This is due to abnormal walking dynamics and pressure distribution caused muscle wasting and atrophy."}]}
{"ops":[{"insert":"Loss of coordination"},{"insert":"\n"}]}
{"ops":[{"insert":"Patients may complain of loss of coordination or clumsiness of the feet. This is because peripheral neuropathy can lead to large fiber neuropathy with loss of vibration and proprioception sense."}]}
{"ops":[{"insert":"Peripheral arterial disease"},{"insert":"\n"}]}
{"ops":[{"insert":"PAD presents with intermittent claudication, gangrene, and increased risk of infection and amputation. This leads to cramping and aching pains in calf muscles, thighs, or buttocks that is aggravated by walking and alleviated by rest. This is due to ischemia."}]}
{"ops":[{"insert":"Ulcers"},{"insert":"\n"}]}
{"ops":[{"insert":"Patients with DFD can present with foot ulcers. These are due to neuropathy and ischemic factors."}]}

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