A review of the Pathophysiology, classification, and treatment of foot ulcers in Diabetic Patients

The number of people with diabetes worldwide was estimated at 131 million in 2000; it is projected to increase to 366 million by 2030.1 Previous studies have indicated that diabetic patients have up to a 25% lifetime risk of developing a foot ulcer.2 The annual incidence of diabetic foot ulcers is ~ 3%, and the reported incidence in U.S. and U.K. studies ranges as high as 10%.3 Once an ulcer has developed, there is an increased risk of wound progression that may ultimately lead to amputation; diabetic ulceration has been shown to precede amputation in up to 85% of cases.3 At least 40% of amputations in diabetic patients can be prevented with a team approach to wound care.4 The purpose of this review is to describe the causes of lower-extremity ulceration in diabetic patients and to identify common methods of classification and treatment to aid primary care providers in determining appropriate treatment approaches for their patients.