Abstract
Diabetes is present in 16 million Americans. Half of all lower extremity amputations in this country occur in this patient group (1). In most cases, the amputation is needed when a foot ulcer does not heal. The incidence of diabetic foot ulcers is 1–4%, whereas the prevalence is 5–10% (2,3). A patient with diabetes has a 15% risk for developing a foot ulcer during his/her lifetime. Six to ten percent of hospitalizations in patients with diabetes are for treatment of foot ulcers; these admissions are about one-quarter of the hospital days in this group of patients.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Reiber G, Lipsky B, Gibbons G. The burden of diabetic foot ulcers. Am J Surg 1998;176:55–105.
Borssen B, Bergenheim T, Lithner F. The epidemiology of foot lesions in diabetic patients aged 15–50 years. Diabet Med 1990;7:438–444.
Moss S, Klein R, Klein B. The prevalence and incidence of lower extremity amputation in a diabetic population. Arch Intern Med 1992;152:610–616.
Rith-Najarian S, Stolusky T, Gohdes D. Identifying diabetic patients at high risk for lower extremity amputation in a primary care setting. Diabetes Care 1992;15:1386–1389.
Reiber G, Boyko E, Smith D. Lower extremity foot ulcers and amputations in diabetes. In: National Diabetes Data Group, ed. Diabetes in America, 2nd ed. Department of Health and Human Services (DHHS), Washington, DC, 1995.
McNeely M, Boyko E, Ahroni J, et al. The independent contributions of diabetic neuropathy and vasculopathy in foot ulceration: how great are the risks? Diabetes Care 1995;18:216–219.
Boulton A, Scarpello J, Ward J. Venous oxygenation in the diabetic neuropathic foot: evidence of arterial venous shunting. Diabetologia 1981;22:6–10.
Weitz J, Byrne J, Clagett G. Diagnosis and treatment of chronic arterial insufficiency of the lower extremities: a critical reviews. Circulation 1996;94:3026–3049.
Bowers B, Valentine R, Myers S. The natural history of patients with claudication with toe pressures of 40 mm Hg or less. J Vasc Surg 1993;18:506–511.
Jaff M, Dorros G. The vascular laboratory: a critical component required for successful management of peripheral arterial occlusive disease. J Endovasc Surg 1998;5:146–158.
Holstein P. The distal blood pressure predicts healing of amputations on the feet. Acta Orthop Scand 1984;55:227–233.
LoGerfo F, Gibbons G, Pomposelli F. Trends in the care of the diabetic foot: expanded role of arterial reconstruction. Arch Surg 1992;127:617–621.
Steed D, Donahoe D, Webster M, Lindsley L. The Diabetic Ulcer Study Group. Effect of extensive debridement and treatment on the healing of diabeticfoot ulcers. J Am Coll Surg 1996;183:61–64.
Foot Care. American Diabetes Association Consensus Conference Report. Diabetes Care, 1999;22.
Helm P, Walker S, Pullium G. Total contact casting in diabetic patients with neuropathic foot ulcerations. Arch Phys Med Rehabil 1984;65:691–693.
Conti S, Martin R, Chaytor E, et al. Plantar pressure measurements during ambulation in weight bearing conventional short leg casts and total contact casts. Foot Ankle Int 1996;17:464–469.
Hunt TK, LaVan EB. Enhancement of wound healing by growth factors. N Engl J Med 1989;321:111–112.
Steed D. Diabetic Ulcer Study Group. Clinical evaluation of recombinant human platelet-derived growth factor for the treatment of lower extremity diabetic ulcers. J Vasc Surg 1995;21:71–81.
Steed D, Goslen J, Holloway A. CT-102 activated platelet supernatant topical versus placebo: a randomized prospective double blind trial in healing of chronic diabetic foot ulcers. Diabetes Care 1992;15:1598–1604.
Wieman J, Smiel J, Steed D. Efficacy and safety of recombinant human platelet derived growth factorBB (becaplermin) in patients with nonhealing lower extremity diabetic ulcers: A phase III randomized double blind study.
Lynch SE, Nixon JC. Role of platelet-derived growth factor in wound healing: synergistic effects with growth factors. Proc Natl Acad Sci USA 1987;84:7696–7697.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2003 Springer Science+Business Media New York
About this chapter
Cite this chapter
Steed, D.L. (2003). The Diabetic Foot. In: Sperling, M.A. (eds) Type 1 Diabetes. Contemporary Endocrinology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-310-1_25
Download citation
DOI: https://doi.org/10.1007/978-1-59259-310-1_25
Publisher Name: Humana Press, Totowa, NJ
Print ISBN: 978-1-61737-258-2
Online ISBN: 978-1-59259-310-1
eBook Packages: Springer Book Archive