Many diabetic foot complications are preventable. This requires a team approach, aiming to identify the high-risk patient and provide appropriate education and foot care. An established ulcer needs careful management with the emphasis on pressure relief and establishing a good blood supply.
ApelqvistJ., BitzenP., LarssonJ., NybergP., ScherstenP.Foot lesions common in a diabetic population older than 25 years.Diabetic Med (in press).
2.
YoungM.J., BoultonA.J.M., MacleodA.F., WilliamsD.R.R., SonksenP.H.A multicentre study of the prevalence of diabetic peripheral neuropathy in the United Kingdom hospital clinic population.Diabetologia1993; 36: 150–4.
3.
BildD.E., SelbyI.V., SinnockP., BrowerW.A.S., BravemanP., ShostackJ.A.Lower extremity amputation in people with diabetes.Diabetes Care1989; 12: 24–31.
4.
ApelqvistJ., TennvallG.R., PerssonU., LarssonJ.Diabetic foot ulcers in a multi-disciplinary setting: an economic analysis of primary healing and healing with amputation.JIntern Med1994; 235: 463–71.
5.
AbbottR.D., BrandF.N., KannellW.B.Epidemiology of some peripheral arterial findings in diabetic men and women: experiences from the Framingham study.Am J Med1990; 88: 376–81.
6.
ShawJ.E., ParkerR., BoultonA.J.M.Risk factors for foot disease in diabetic nephropathy.Eur J Clin Invest1995; 25(Suppl 2): A59.
7.
BoultonA.J.M.The diabetic foot: neuropathic in aetiology?Diabetic Med1990; 7: 852–8.
8.
BoultonA.J.M.Peripheral neuropathy and the diabetic foot.The Foot1992; 2: 67–72.
9.
YoungM.J., BreddyJ.L., V evesA., BoultonA.J.M.The prediction of neuropathic foot ulceration using vibration perception thresholds.Diabetes Care1994; 17: 557–61.
10.
V evesA., MurrayH.J., YoungM.J., BoultonA.J.M.The risk of foot ulceration in diabetic patients with high foot pressure: a prospective study.Diabetologia1992; 35: 660–3.
11.
BoultonA.J.M., ScarpelloJ.H.B., WardJ.D.Venous oxygenation in the diabetic neuropathic foot. Evidence of arteriovenous shunting?Diabetologia1982; 22: 6–8.
12.
MurrayH.J., YoungM.J., BoultonA.J.M.Relationship between callus formation, pressures and neuropathy in diabetic foot ulceration.Diabetic Med1994; 11(Suppl 2): 5.
13.
MaloneJ.M., SnyderM., AndersonG.Prevention of amputation by diabetic education.Am J Surg1989; 158: 520–4.
14.
EdmondsM.E., BlundellM.P., MorrisM.E.Improved survival of the diabetic foot: the role of a specialised foot clinic.Q J Med1986; 60: 763–71.
15.
KumarS., FernandoD.J.S., VevesA., KnowlesE.A., YoungM.J., BoultonA.J.M.Semmes-Weinsteinmonofilaments: a simple, effective and inexpensive screening device for identifying diabetic patients at risk of foot ulceration.Diabetes Res Clin Pract1991; 13: 63–8.
16.
V evesA., MassonE.A., FernandoD.J., BoultonA.J.M.Studies of experimental hosiery in diabetic neuropathic patients with high foot pressures.Diabetic Med1990; 7: 324–6.
17.
MartinasevicM., MohanC.R., SchueppertM.A comparison of the long term results with autogenous vein bypass for lower extremity revascularisation between diabetics and non-diabetics.Diabetic Med (in press).
18.
PringD.J., CasiebancaN.Simple plantar ulcers treated by below knee plaster and molded double-rocker plaster shoe: a comparative study.Lepr Rev1977; 53: 261–4.
19.
LaingP.W., CogleyD.I., KlenermanL.Neuropathic foot ulceration treated by total contact casts.J Bone Joint Surg (Br)1991; 74: 133–6.
20.
BoultonA.J.M., BowkerJ.H., GadiaM.Use of plaster casts in the management of diabetic neuropathic foot ulcers.Diabetes Care1986; 9: 149–52.
21.
BurdenA.C., JonesG.R., JonesR., BlandfordR.L.Use of the Scotchcast boot in treating diabetic foot ulcers.Br Med J1983; 186: 1555–7.
22.
CaputoG.Infection: investigation and management. In: BoultonA.J.M., ConnorH., CavanaghP.R. eds. The foot in diabetes;2nd ed.Chichester: John Wiley, 1994: 203–10.
23.
EdmondsM.E., ClarkeM.B., NewtonS., BarrettJ., WatkinsP.J.Increased uptake of bone radiopharmaceutical in diabetic neuropathy.Q J Med1985; 57: 843–55.
24.
YoungM.J., MarshallA., AdamsJ.E., SelbyP.L., BoultonA.J.M.Osteopenia, neurological dysfunction and the development of Charcot neuroarthropathy.Diabetes Care1995; 18: 34–8.