The diabetic foot: an overview of assessment and complications.

Diabetic foot problems are a common complication of diabetes mellitus and can lead to morbidity and mortality. Foot disease is the leading cause of non-traumatic lower-limb amputation in the developed world (National Institute for Health and Clinical Excellence (NICE), 2004). Diabetic foot disease is a result of three main pathologies, which can occur singly or in combination. These are: peripheral neuropathy, peripheral arterial disease and infection. Consequences of these pathologies are ulceration, Charcot foot, painful neuropathy, gangrene and amputation (NICE, 2004). This article offers a podiatrist perspective of the management of diabetic foot problems, from initial assessment to the management of complex foot disease. Patients with a diabetic foot problem must be assessed thoroughly and referred to the local multidisciplinary team, where appropriate (NICE, 2004). Recurrence of ulcers is common, and therefore good foot health education, adequate footwear and regular podiatry, if required, must be an integral part of the patient's review process (NICE, 2004).