The Pathway to Foot Ulceration in Diabetes

At any one time 2% to 4% of the diabetic population is likely to have an active foot ulcer. Peripheral neuropathy, foot deformity, and trauma (often from ill-fitting footwear) represent the commonest causal pathway to foot ulceration. All patients with diabetes require an annual foot screen, and those found to be at risk require specialist foot care and preventive foot-care education. Identification of the high-risk foot can be achieved without the need for expensive equipment. Understanding the implications of loss of protective sensation is essential in reducing the all too high incidence of foot problems in diabetes.