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Diabetic Foot Complications: Diagnosis and Management

Division of Podiatry, Beth Israel Deaconess Medical Center, Joslin Diabetes Center, Joslin-Beth Israel Deaconess Foot Center and Division of Surgery, Harvard Medical School, Boston, MA

Thomas E. Lyons, DPM

Joslin-Beth Israel Deaconess Foot Center; and Surgery, Harvard Medical School, Boston, MA, tlyons{at}bidmc.harvard.edu

Foot complications in patients with diabetes mellitus are a challenge to the health care industry. A great deal of expenditure is due to the management of diabetic foot complications. This places a great burden on the health care industry. It also places a great burden on those diabetic patients with foot complications and their families. Therefore, their effective management in an efficient manner is crucial to our patients. To deal with these problems, a dedicated, knowledgeable, and experienced multidisciplinary team is key. Intervention at the earliest possible time yields the best outcome. Prevention is the focus for those with no ulcerations. For those with ulcerations, prompt recognition and treatment is key. The importance of classifying ulcerations according to size, depth, presence or absence of infection, and vascular status can not be overstated. Proper offloading is vital for those with neuropathic lesions. Recognition of patients with a component of ischemia and vascular intervention to increase perfusion will aid in wound healing. Of course deep infection requires immediate drainage. All efforts of those in the multidisciplinary team are directed at the restoration and maintenance of an ulcer-free foot which is important in enabling our patients to maintain their ambulatory status.

Key Words: diabetic foot disease • podiatry • vascular surgery • complications

The International Journal of Lower Extremity Wounds, Vol. 4, No. 3, 171-182 (2005)
DOI: 10.1177/1534734605280136


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