Abstract
The understanding and reporting of the exact pathomechanics of a diabetic foot syndrome could be a highly complex process. However, the major pathogenesis mechanism is regulated by the changes in both metabolic and vascular factors. Under the metabolic factors, hyperglycemia has the highest contribution leading to axonal and microvascular injuries. The neuropathy symptoms are associated with damage to nerve fibers although less evidence is published regarding its pathogenesis. The possible explanation could be referenced to a study which found the microvascular defects using the sural nerve biopsy among patients with neuropathy. The mechanism for pathogenesis of diabetic foot syndrome could be well explained based on the etiological factors as discussed below.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Bacarin TA, Sacco IC, Hennig EM (2009) Plantar pressure distribution patterns during gait in diabetic neuropathy patients with a history of foot ulcers. Clinics 64(2):113–120
Birtane M, Tuna H (2004) The evaluation of plantar pressure distribution in obese and non-obese adults. Clin Biomech 19(10):1055–1059
Boulton AJ (2000) The diabetic foot: a global view. Diabetes Metab Res Rev 16(S1):S2–S5
Boulton AJ (2013) The pathway to foot ulceration in diabetes. Med Clin N Am 97(5):775–790
Bus SA (2008) Foot structure and footwear prescription in diabetes mellitus. Diabetes Metab Res Rev 24(S1):S90–S95
Caselli A, Pham H, Giurini JM, Armstrong DG, Veves A (2002) The forefoot-to-rearfoot plantar pressure ratio is increased in severe diabetic neuropathy and can predict foot ulceration. Diabetes Care 25(6):1066–1071
Chawla J (2011) Stepwise approach to myopathy in systemic disease. Front Neurol 2:49
Dyck PJ, Herrmann DN, Staff NP, Dyck PJB (2013) Assessing decreased sensation and increased sensory phenomena in diabetic polyneuropathies. Diabetes 62(11):3677–3686
Hills AP, Hennig EM, McDonald M, Bar-Or O (2001) Plantar pressure differences between obese and non-obese adults: a biomechanical analysis. Int J Obes 25(11):1674
Kwon OY, Tuttle LJ, Johnson JE, Mueller MJ (2009) Muscle imbalance and reduced ankle joint motion in people with hammer toe deformity. Clin Biomech 24(8):670–675
Ledoux WR, Shofer JB, Cowley MS, Ahroni JH, Cohen V, Boyko EJ (2013) Diabetic foot ulcer incidence in relation to plantar pressure magnitude and measurement location. J Diabetes Complicat 27(6):621–626
Levin ME, O’Neal LW (1988) The diabetic foot: pathophysiology, evaluation, and treatment. The diabetic foot. C. V. Mosby Company, St. Louis, pp 1–50
Menz HB, Morris ME (2006) Clinical determinants of plantar forces and pressures during walking in older people. Gait Posture 24(2):229–236
Murray HJ, Young MJ, Hollis S, Boulton AJ (1996) The association between callus formation, high pressures and neuropathy in diabetic foot ulceration. Diabet Med 13(11):979–982
Oyibo SO, Jude EB, Tarawneh I, Nguyen HC, Armstrong DG, Harkless LB, Boulton AJM (2001) The effects of ulcer size and site, patient’s age, sex and type and duration of diabetes on the outcome of diabetic foot ulcers. Diabet Med 18(2):133–138
Payne C, Turner D, Miller K (2002) Determinants of plantar pressures in the diabetic foot. J Diabetes Complicat 16(4):277–283
Petrofsky J, Berk L, Al-Nakhli H (2012) The influence of autonomic dysfunction associated with aging and type 2 diabetes on daily life activities. Exp Diabetes Res 2012:657103
Reiber G, Lipsky B, Gibbons G (1998) The burden of diabetic foot ulcers. Am J Surg 176(2):5S–10S
Rosyid, FN (2017) Etiology, pathophysiology, diagnosis and management of diabetics’ foot ulcer. Int J Res Med Sci, 5(10):4206–4213
Rebolledo FA, Soto JT, de la Peña JE (2011) The pathogenesis of the diabetic foot ulcer: prevention and management pp. 155–178. (InTech.)
Sawacha Z, Guarneri G, Cristoferi G, Guiotto A, Avogaro A, Cobelli C (2012a) Integrated kinematics–kinetics–plantar pressure data analysis: a useful tool for characterizing diabetic foot biomechanics. Gait Posture 36(1):20–26
Sawacha Z, Spolaor F, Guarneri G, Contessa P, Carraro E, Venturin A, Avogaro A, Cobelli C (2012b) Abnormal muscle activation during gait in diabetes patients with and without neuropathy. Gait Posture 35(1):101–105
Simandl G, Porth CM (1990) Alteration in skin function and integrity. In: Pathophysiology, concepts of altered health states, 3rd edn. JB Lippincott Company, Philadelphia, pp 108–140
Stadler RW, Lu SN, King GW, Moore TR, Medtronic Inc (2006) Method and apparatus for gauging severity of myocardial ischemic episodes. U.S. Patent 7,066,891
Van Rensburg G (2011) Foot ulceration in diabetes: the biomechanical factor: podiatry. Wound Healing S Afr 4(1):38–43
Verrotti A, Prezioso G, Scattoni R, Chiarelli F (2014) Autonomic neuropathy in diabetes mellitus. Front Endocrinol 5:205
Veves A, Murray HJ, Young MJ, Boulton AJM (1992) The risk of foot ulceration in diabetic patients with high foot pressure: a prospective study. Diabetologia 35(7):660–663
Waaijman R, Arts MLJ, Haspels R, Busch-Westbroek TE, Nollet F, Bus SA (2012) Pressure-reduction and preservation in custom-made footwear of patients with diabetes and a history of plantar ulceration. Diabet Med 29(12):1542–1549
Yazdanpanah L, Nasiri M, Adarvishi S (2015) Literature review on the management of diabetic foot ulcer. World J Diabetes 6(1):37
Young MJ, Veves A, Boulton AJ (1993) The diabetic foot: aetiopathogenesis and management. Diabetes Metab Res Rev 9(2):109–127
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
Copyright information
© 2020 Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Hazari, A., Maiya, G.A. (2020). Pathomechanics of Diabetic Foot Syndrome. In: Clinical Biomechanics and its Implications on Diabetic Foot. Springer, Singapore. https://doi.org/10.1007/978-981-15-3681-6_3
Download citation
DOI: https://doi.org/10.1007/978-981-15-3681-6_3
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-15-3680-9
Online ISBN: 978-981-15-3681-6
eBook Packages: MedicineMedicine (R0)