title: Diabetic foot ulcers: Part I. Pathophysiology and prevention.
abstract: Diabetes mellitus is a serious, life-long condition that is the sixth leading cause of death in North America. Dermatologists frequently encounter patients with diabetes mellitus. Up to 25% of patients with diabetes mellitus will develop diabetic foot ulcers. Foot ulcer patients have an increased risk of amputation and increased mortality rate. The high-risk diabetic foot can be identified with a simplified screening, and subsequent foot ulcers can be prevented. Early recognition of the high-risk foot and timely treatment will save legs and improve patients' quality of life. Peripheral arterial disease, neuropathy, deformity, previous amputation, and infection are the main factors contributing to the development of diabetic foot ulcers. Early recognition of the high-risk foot is imperative to decrease the rates of mortality and morbidity. An interprofessional approach (ie, physicians, nurses, and foot care specialists) is often needed to support patients' needs.
authors.affiliation: Department of Medicine (Dermatology), University of Toronto, Toronto, Ontario, Canada; Wound Care Centre, Women's College Hospital, Toronto, Ontario, Canada. Electronic address: afsaneh.alavi@utoronto.ca.
authors.forename: Afsaneh
authors.initials: A
authors.lastname: Alavi
authors.affiliation: Department of Medicine (Dermatology), University of Toronto, Toronto, Ontario, Canada; Department of Medicine (Dermatology) and Public Health, University of Toronto, Toronto, Ontario, Canada; Wound Care Centre, Women's College Hospital, Toronto, Ontario, Canada.
authors.forename: R Gary
authors.initials: RG
authors.lastname: Sibbald
authors.affiliation: Clinic for Cardiovascular Surgery, University Hospital of Zurich, Zurich, Switzerland.
authors.forename: Dieter
authors.initials: D
authors.lastname: Mayer
authors.affiliation: Wound-Healing Clinic, Mississauga, Ontario, Canada.
authors.forename: Laurie
authors.initials: L
authors.lastname: Goodman
authors.affiliation: Wound Care Centre, Women's College Hospital, Toronto, Ontario, Canada.
authors.forename: Mariam
authors.initials: M
authors.lastname: Botros
authors.affiliation: Department of Surgery, the University of Arizona College of Medicine/SALSA, Tucson, Arizona.
authors.forename: David G
authors.initials: DG
authors.lastname: Armstrong
authors.affiliation: Faculty of Nursing, Queen's University, Kingston, Ontario, Canada.
authors.forename: Kevin
authors.initials: K
authors.lastname: Woo
authors.affiliation: Department of Prosthetics and Orthotics, University of Zurich, Zurich, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Boeni
authors.affiliation: Excelsior College, School of Nursing, Albany, New York.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Ayello
authors.affiliation: Department of Dermatology and Cutaneous Surgery, University of Miami, Miami, Florida.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Kirsner
mesh_terms: D000671:Amputation, Surgical / Q000009:adverse effects; D017719:Diabetic Foot / Q000145:classification / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D058729:Peripheral Arterial Disease / Q000150:complications; D011312:Pressure / Q000009:adverse effects; D012307:Risk Factors
keywords: diabetes; diabetic foot ulcer; neuropathy; wounds