Approach to managing diabetic foot ulcers.
BACKGROUND
Of an estimated 1.7 to 2 million Canadians with diabetes, approximately 10% will present each year to their family doctors with plantar ulcers. Nearly 3500 will require major lower extremity amputations.


METHODS
Most of the recommendations outlined in this paper are based on level I evidence from excellent bench research and epidemiologic studies.


RESULTS
Both insulin-dependent and non-insulin-dependent diabetics develop foot infections. These patients are on average 60 years old and have had diabetes for more than 10 years. Physicians who insist on excellent blood sugar control, provide ongoing patient education on diabetic foot care, prescribe appropriate shoes, and practise an aggressive multidisciplinary approach to wound care can reduce the rate of lower extremity amputations by more than 50%.


CONCLUSIONS
Foot problems remain one of the main challenges associated with diabetes, but family physicians can manage them successfully.
Nesbitt
John A A
JA
Calgary Foot and Ulcer Care Clinic, Alta. jnesbittmd@shaw.ca
D000465:Algorithms; D001774:Blood Chemical Analysis; D017719:Diabetic Foot / Q000175:diagnosis / Q000628:therapy*; D005194:Family Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D012648:Self Care