Introduction

Complications involving the foot are common in patients with diabetes mellitus. Manifestations of these complications range from the simple to more complex entities, which are limb or even life threatening. The treatment of these complications ranges from simple office-based interventions to prolonged hospitalizations. Foot pathology remains the leading diabetic complication requiring hospitalization (1). The incidence of diabetes in the general population is expected to rise as well as the prevalence of diabetic foot complications is likely to increase. The costs of these complications are owing not only to the medical costs, but also because of costs of lost productivity. For example, in 2002, the medical costs for treating patients with diabetes mellitus was 92 billion. An additional 40 billion could be attributable to lost productivity. The number of people diagnosed with diabetes mellitus is expected to increase as will the cost of treatment. It is projected that the costs of treatment will increase to approximately 160 billion by 2010 and near 200 billion by 2020 (2).

From: Contemporary Diabetes: Diabetic Neuropathy: Clinical Management, Second Edition Edited by: A. Veves and R. Malik © Humana Press Inc., Totowa, NJ

Diabetic foot complications therefore represent a major public health challenge of growing proportions.

Relatively recently, risk factors and causal pathways leading to diabetic foot problems have been identified. The importance of the major risk factors for the development of diabetic foot ulcers, which include peripheral neuropathy, peripheral vascular disease, and high foot pressures is well known. These, along with other factors result in the development of diabetic foot complications, which will be discussed later in the chapter. It is hoped that better appreciation of the pathogenesis of diabetic foot complications will afford us effective and successful preventative strategies aimed at limb salvage.

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