What Physician should know
diabetic foot ulecer precede 85% of nontraumatic lower-exteremity amputation (LEAs). approximatelly 3- 4 % of individual with diabetes currentyl have foot ulcer or deep infektion. fiiteen percent develop foot ulcer during their lifetime. ther risk of LEA increases by a factor of 8 onece an ulcer develops.
etiology of diabetic foot is including peripheral neuropaty, ischemic vascular disease and immune dficiency. the primary risk factor for the developmen of diabetic foot ulcer is loss of pertectice sensation. abnormal white blood cell fungtion and the presence of peripheral vascular disease allow wounds to become cotaminated and infected by normaly nonpathogenic organism. this explains he indetifiacation of unusual bacteria form the wound of patien with diabetec.
ischemic pherpheral disesase is tehe second risk factor for developing diabetic foot ulcer and infection. this used to be considered a smal vessel disease, but curren research links the vascular pathology to the basement membrane of the artierial wall. the disease is similar to that in those with vasular disease who are not diabetic, except that the distribution is somewhat more scattered and geographic in person who are not diabetic, as opposed to progressive in a distal direction in person who ara diabetic.
the third major risk factor related to the immune deficciency seen in this patient population, glycosylated immune proteins lose efficency, and granulocytes do not perform adequately, leavieng these patients prrone to infection form organisms that not affect a healthy host. each of these potential abnormallities make the diabetic foot susceptible to abnormal mechanical stresses that can lead to a break in the normal soft tissue envelope, which can intiate a foot infection that cannot be resolved easeily
management of diabetic foot and peripheral artery disease in diabetic patient need a comprehensive treatmen consisist of an optimal control of blood glucose, wound care and treating of peripheral artery disease is crucial as well, either medication or evdovascular intervation wich leads to be better outcome in terms of preserving lims.
original article from ASMIHA 16 by Iwan Dakota
Devision of Vascular Medicine, National Cardiovascular Center Harapan Kita - Jakarta
etiology of diabetic foot is including peripheral neuropaty, ischemic vascular disease and immune dficiency. the primary risk factor for the developmen of diabetic foot ulcer is loss of pertectice sensation. abnormal white blood cell fungtion and the presence of peripheral vascular disease allow wounds to become cotaminated and infected by normaly nonpathogenic organism. this explains he indetifiacation of unusual bacteria form the wound of patien with diabetec.
ischemic pherpheral disesase is tehe second risk factor for developing diabetic foot ulcer and infection. this used to be considered a smal vessel disease, but curren research links the vascular pathology to the basement membrane of the artierial wall. the disease is similar to that in those with vasular disease who are not diabetic, except that the distribution is somewhat more scattered and geographic in person who are not diabetic, as opposed to progressive in a distal direction in person who ara diabetic.
the third major risk factor related to the immune deficciency seen in this patient population, glycosylated immune proteins lose efficency, and granulocytes do not perform adequately, leavieng these patients prrone to infection form organisms that not affect a healthy host. each of these potential abnormallities make the diabetic foot susceptible to abnormal mechanical stresses that can lead to a break in the normal soft tissue envelope, which can intiate a foot infection that cannot be resolved easeily
management of diabetic foot and peripheral artery disease in diabetic patient need a comprehensive treatmen consisist of an optimal control of blood glucose, wound care and treating of peripheral artery disease is crucial as well, either medication or evdovascular intervation wich leads to be better outcome in terms of preserving lims.
original article from ASMIHA 16 by Iwan Dakota
Devision of Vascular Medicine, National Cardiovascular Center Harapan Kita - Jakarta
