REVIEW PAPER
Diabetic foot – the need for comprehensive multidisciplinary approach
1
Department of Hypertension and Diabetology Medical University, Gdańsk, Poland
2
Diabetology Department, Institute of Rural Health, Lublin, Poland; Pope John Paul II State School of Higher Education in Biała Podlaska Institute of Public Health, Poland
Ann Agric Environ Med. 2011;18(2):314-317
KEYWORDS
Diabetic Footulcerationinfectionischemiaamputationmultidisciplinary foot clinicsenvironmental factors
ABSTRACT
Diabetes mellitus is considered to be civilization disease development of which is influenced by environmental changes. Diabetic foot (ulceration, infection, gangrene) is one of the most disabling complication of diabetes mellitus. It contributes to the increased mortality and cardiovascular death.
It also frequently leads to depression, social exclusion and physical impairment. Risk factors of diabetic foot are as follows: age, race, sex, duration of diabetes, biomechanical factors, level of glycemia, smoking habits.
According to international standards diabetic foot can be successfully treated only by the multidisciplinary team which can provide more comprehensive and integrated care as compared to ordinary medical team or single specialist.
Multidisciplinary team consists of: diabetologist, shoemaker, orthopedist, psychologist, surgeons both vascular and general, podologists, radiologists, educators, nurses and rehabilitation team.
Such coordinated attitude to a patient may be the future solution for any civilization and environment-related disease requiring treatment which cannot be successfully provided by any ordinary medical team.
REFERENCES (42)
1.
Boulton AJ. Th e diabetic foot: a global view. Diabetes Metab Res Rev 2000; 16 (suppl):S2-5. Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. Jama 2005;293:217-28.
2.
Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. Jama 2005;293:217-28.
3.
Pecoraro RE, Reiber GE, Burgess EM. Pathways to diabetic limb amputation. Basis for prevention. Diabetes Care 1990;13:513-21.
5.
Korzon-Burakowska A, Skuratowicz-Kubica A, Tęcza S. et al. Analysis of in-hospital course and treatment outcomes in patients with diabetic foot syndrome in the Department of Hypertension and Diabetology, Medical University of Gdańsk in the 2008 year. Diabetologia Praktyczna 2010;11(6):204-209 (in Polish).
6.
Skuratowicz-Kubica A. Korzon-Burakowska A, Michalski G, Chrostowska M, Jasiel-Wojculewicz H, Wyrzykowski B. Clinical course and hospitalisation costs of patients with diabetic foot ulcers hospitalized in the Department of Hypertension and Diabetology Medical University of Gdańsk in the year 2005. Diabetologia Doświadczalna i Kliniczna 2007;7(3):139-143.
8.
Jeff coate W, Bakker K. World Diabetes Day: footing the bill. Lancet 2005;365:1527.
9.
American Cancer Society. Cancer Facts and Figures. Atlanta: American Cancer Society 2000.
10.
Kulkarni J, Pande S, Morris J. Survival rates in dysvascular lower limb amputees. Int J Surg 2006;4:217-221.
11.
Stansbury LG, Branstetter JG, Lalliss SJ. Amputation in military trauma surgery. J Trauma 2007;63:940-944.
12.
Burkitt DP. Some Diseases Characteristic of Modern Western Civilization. British Medical Journal 1973;1:274-278.
13.
Hu FB, Manson JE, Stampfer MJ, Colditz G, Liu S, Solomon CG, Willet WC. Diet, Lifestyle, And Th e Risk Of Type 2 Diabetes Mellitus In Women. Th e New England Journal of Medicine 2001;345(11):790- 797.
14.
Zimmet P, Alberti KG, Shaw J. Global and societal implications of the diabetes epidemic. Nature 2001;13(414):782-787.
15.
Diabetes Control and Complications Trial Research Group: Th e eff ect of intensivediabetes therapy on the development and progression of neuropathy. Ann Intern Med 1995;122:561–568.
16.
Martin CL, Albers J, Herman WH, Cleary P, Waberski B, Greene DA, et al. Neuropathy Among the Diabetes Control and Complications Trial Cohort 8 Years Aft er Trial Completion. Diabetes Care 2006;29:340- 344.
17.
Ismail K, Winkley K, Stahl D, Chalder T, Edmonds M. A Cohort Study of People With Diabetes and Th eir First Foot Ulcer. Th e role of depression on mortality Diabetes Care 2007;30(6):1473-1479.
18.
Reiber GE, Vileikyte L, Boyko EJ, Del Aguila M, Smith DG, Lavery LA, Boulton AJ M. Causal Pathways for Incident Lower- Extremity Ulcers in Patients With Diabetes From Two Settings Diabetes Care 1999;22:157-162.
19.
Fraser GE, Shavlik DJ. Ten Years of Life Is It a Matter of Choice? Arch Intern Med 2001;161:1645-1652.
20.
Merza Z, Tesfaye S. Th e risk factors for diabetic foot ulceration. Th e Foot 2003;13:125-129.
21.
Nather A, Bee CS, Lin WK, Koh Si Qi, Huak CY, Xinyi L, Nambiar A. Socioeconomic profi le of diabetic patients with and without foot problems. Diabetic Foot & Ankle 2010;1:5523 -28.
22.
Peters EJ, Lavery LA, Armstrong DG. Diabetic Lower extremity infection – infl uence of physical psychological and social factors. J Diab Complicat 2005;19(2):107-12.
23.
van Houtum WH, Lavery LA, Harkless LB. Th e impact of diabetesrelated lower-extremity amputations in Th e Netherlands. J Diabetes Complications 1996;10(6):325-30.
24.
Herman W, Kennedy L. for the GOAL A1C Study Group: Underdiagnosis of Peripheral Neuropathy in Type 2 Diabetes. Diabetes Care 2005;28(6):1480-1481.
25.
O’Brien KE, Chandramohan V, NelsonDA, Fischer JR Jr, Stevens G, Poremba JA. Eff ect of a physician-directed educational campaign on performance of proper diabetic foot exams in an outpatient setting. J Gen Intern Med 2003;18:258-265.
26.
Young MJ, Veves A, Breddy JL, Boulton AJM. Th e prediction of diabetic neuropathic foot ulceration using vibration perception thresholds: a prospective study. Diabetes Care 1994;17:557-560.
27.
Dyck PJ, Katz KM, Karnes JL, Litchy WJ, Klein R, Pach JM. Th e prevalence by staged severity of various types of diabetic neuropathy,retinopathy and nephropathy in a population based cohort: the Rochester Diabetic Neuropathy study. Neurology 1993;43:817-824.
28.
Reiber GR, Smith DG, Wallace C, Sullivan K, Hayes S, Vath C, Maciejewski ML, et al. Eff ect of Th erapeutic Footwear on Foot Reulceration in Patients With Diabetes. A Randomized Controlled Trial. JAMA 2002;287(19):2552-2558.
29.
Prompers L et al.Prediction of outcome in individuals with diabetic foot ulcers: focus on the diff erences between individuals with and without peripheral arterial disease. Th e EURODIALE Study. Diabetologia 2008;51(5):747-55.
30.
Reiber GE, Pecoraro RE, Koepsell TD. Risk factors for amputation in patients with diabetes mellitus. A case-control study. Ann Intern Med 1992;117:97-105.
31.
Armstrong DG, Lavery LA, Harkless LB. Validation of a diabetic wound classifi cation system. Th e contribution of depth, infection, and ischemia to risk of amputation. Diabetes Care 1998;21:855-859.
32.
Smith D, Weinberger M, et al. A controlled trial to increase offi ce visits and reduce hospitalization in diabetic patients. J General Int Med 1998;2:232-8.
33.
Eneroth M, Apelqvist J, Stenstrom A. Clinical characteristics and outcome in 223 diabetic patients with deep foot infections. Foot Ankle Int 1997;18:716-722.
34.
Rajbhandari S, Jenkins R, Davies C et al. Charcot neuroarthropathy in diabetes mellitus. Diabetologia 2002; 45:1085-1096.
35.
Frykberg R, Belczyk R. Epidemiology of the Charcot foot. Clin Podiatr Med Surg 2008;25(1):17-28.
36.
Reiber GE, Boyko EJ, Smith DC. Lower extremity foot ulcers and amputations in diabetes. In: Diabetes in America. 2nd ed. Washington, DC: National Diabetes Data Group, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health; 1995: 409.
37.
Holstein PE, Sorensen S. Limb salvage experience in a multidisciplinary diabetic foot unit. Diabetes Care 1999;22(suppl 2):B97-103.
38.
Brand PW. Th e Diabetic Foot. In: Ellenberg M,Rifk in H (eds) Diabetes mellitus: theory and practice, 3rd edn. Med Exam Publishing, New York, 1983:pp 829-849.
39.
Tochman-Gawda A, Paprzycki P, Dziemidok P. A tuning fork or a biothesiometer: which one to choose in the outpatient diabetes care? Diabetologia Doświadczalna i Kliniczna 2007;7(1):1-7.
40.
Trautner C, Haastert B, Spraul M, Giani C, Berger M. Unchanged incidence of lower limb amputations in a German city 1990–1998. Diabetes Care 2001;24:855-859.
41.
Ragnarson-Tennvall G, Apelqvist J. Prevention of diabetes-related foot ulcers and amputations: a cost-utility analysis based on Markov model simulation. Diabetologia 2001;44:2077-2087.
42.
Korzon-Burakowska A, Skuratowicz-Kubica A, Wyrzykowski B. Th e costs of health provider in the treatment of the diabetic foot patients in the Diabetic Foot Clinic Diabetic Regional Centre Medical University in Gdańsk in the year 2007 Diabetologia Praktyczna 2010;11( 2):246- 48.
Share
RELATED ARTICLE
| eISSN: | 1898-2263 |
| ISSN: | 1232-1966 |
Improvement of visual identification of the journal - task financed under the agreement No. 618/P-DUN/2019 by the Minister of Science and Higher Education allocated to the activities of disseminating science.
Generation of the DOI (Digital Object Identifier) - task financed under the agreement No. 618/P-DUN/2019 by the Minister of Science and Higher
© 2006-2024 Journal hosting platform by Bentus
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
