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Lee and Chung: Diabetic Foot: Past and Present
Statement

J Korean Diabetes 2011;12(2):69-71.

Published online: 22 January 2011

DOI: https://doi.org/10.4093/jkd.2011.12.2.69

Diabetic Foot: Past and Present

Ji Ho Lee1, Choon Hee Chung1, 2

1Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea

2Diabetes Center, Wonju Christian Hospital, Yonsei University, Wonju, Korea

Copyright © 2011 Korean Diabetes Association

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Diabetic foot is one of the most serious complications of diabetes, and is associated with significant portions of admission, medical cost, disability and mortality in diabetic patients. According to a recent report from the Korean Diabetes Association Basic Statistics Research Task Force Team, 1.2% of Korean diabetic patients had diabetic foot, representing a decrease since 1980. The age at amputation increased since 1980, from 60 to 70 years of age, while the mortality rate decreased due to advances of therapeutic technology. Further epidemiologic studies are required to obtain current data regarding incidence, amputation rates, and mortality, and to identify risk factors and new therapeutic modalities in diabetic foot.

Keywords: Diabetic foot, Amputation, Ulcer, Epidemiology

REFERENCES

1. Diabetic Foot. Korean Diabetes Association. Diabetes Mellitus. Seoul: Korean Diabetes Association;2006. p. 518–26.
2. Boulton AJM. Foot problems in patients with diabetes mellitus. Pickup JC, Williams G, editors. Textbook of diabetes. Vol. 2. Oxford: Blackwell Science;1997. p. 58.
3. Most RS, Sinnock P. The epidemiology of lower extremity amputations in diabetic individuals. Diabetes Care. 1983; 6:87–91.
crossref
4. Siitonen OI, Niskanen LK, Laakso M, Siitonen JT, Pyörälä K. Lower-extremity amputations in diabetic and nondiabetic patients. A population-based study in eastern Finland. Diabetes Care. 1993; 16:16–20.
crossref
5. Boyko EJ, Ahroni JH, Smith DG, Davignon D. Increased mortality associated with diabetic foot ulcer. Diabet Med. 1996; 13:967–72.
crossref
6. Rowbotham JL, Gibbons GW, Kozak GP. The diabetic foot. Kozak GP, editor. Kozak's clinical diabetes mellitus. Philadelphia: W.B. Saunders Co.;1982. p. 215–28.
7. Lee MK, Chung MH, Won AO, Kim SY, Lee HK, Min HK. A clinical observation on the diabetic foot lesions. J Korean Diabetes Assoc. 1984; 8:55–65.
8. Kwon YJ, Han KA, Sung SK, Yoo HJ. A clinical study on the diabetic foot lesions. J Korean Diabetes Assoc. 1989; 13:39–45.
9. Chung CH, Kim DJ, Kim J, Kim H, Kim H, Min KW, Park SW, Park JH, Baik SH, Son HS, Ahn CW, Oh JY, Lee S, Lee J, Choi KM, Choi I, Park IB. Current status of diabetic foot in Korean patients using National Health Insurance database. J Korean Diabetes Assoc. 2006; 30:372–6.
crossref
10. Boulton AJM, Cavanagh PR, Rayman G. The description and classification of diabetic foot lesions: systems for clinical care, for research and for audit. The description and classification of diabetic foot lesions: systems for clinical care, for research and for audit. Jeffcoate WJ, Game FL, editors. The foot in diabetes. 4th ed.Chichester: John Wiley & Sons, Ltd.;2006. p. 92–107.
11. Altavilla D, Bitto A, Polito F, Marini H, Minutoli L, Di Stefano V, Irrera N, Cattarini G, Squadrito F. Polydeoxyribonucleotide (PDRN): a safe approach to induce therapeutic angiogenesis in peripheral artery occlusive disease and in diabetic foot ulcers. Cardiovasc Hematol Agents Med Chem. 2009; 7:313–21.
crossref
12. Villela DL, Santos VL. Evidence on the use of platelet-rich plasma for diabetic ulcer: a systematic review. Growth Factors. 2010; 28:111–6.
crossref
13. O'Loughlin A, McIntosh C, Dinneen SF, O'Brien T. Review paper: basic concepts to novel therapies: a review of the diabetic foot. Int J Low Extrem Wounds. 2010; 9:90–102.
14. Teng YJ, Li YP, Wang JW, Yang KH, Zhang YC, Wang YJ, Tian JH, Ma B, Wang JM, Yan X. Bioengineered skin in diabetic foot ulcers. Diabetes Obes Metab. 2010; 12:307–15.
crossref
15. Kim JH, Jung M, Kim HS, Kim YM, Choi EH. Adipose-derived stem cells as a new therapeutic modality for ageing skin. Exp Dermatol. 2011; 20:383–7.
crossref

Table 1.
The University of Texas (UT) classification of diabetic ulcers
Grade Stage
Stage 0 1 2 3
A Completely epithelialized wound Superficial wound Wound penetrates to tendon or capsule Wound penetrates to bone or joint
B + Infection + Infection + Infection + Infection
C + Ischemia + Ischemia + Ischemia + Ischemia
D + Infection and ischemia + Infection and ischemia + Infection and ischemia + Infection and ischemia
Table 2.
The S(AD)SAD classification of diabetic foot ulcers
Size
Grade Area Depth Sepsis Arteriopathy Denervation
0 Skin intact Skin intact None Pedal pulses present Pin pricks intact
1 < 1 cm2 Superficial (skin and subcutaneous tissue) Surface Pedal pulses reduced or one missing Pin pricks reduced
2 1-3 cm2 Tendon, periosteum, joint capsule Cellulitis Absence of both Pedal pulses Pin pricks absent
3 cm2 Bone or joint space Osteomyelitis Gangrene Charcot
Table 3.
The SINBAD system for classifying foot lesions
Site and side
Ischemic? Yes/No If yes, is the ischemia critical? Yes/No
Neuropathy? Yes/No If yes, does the patient have Charcot? Yes/No
Bacterial infection? Yes/No If yes, is there osetomyelitis? Yes/No
0 1 2 3
Area Skin intact 1 cm2 1-3 cm2 3 cm2
Depth Skin intact Superficial Deep Bone
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