Diabetic Foot

Question 1

Diabetes prevalence UK

Answer 1

4.4 million

Question 2

What % of NHS budget spent of diabetes

Answer 2

10%

Question 3

Causes of diabetic foot

Answer 3

Sensory neuropathy
Charcot foot
PAD
Ulceration
Infection

Question 4

What is neuropathy

Answer 4

Early complication of T2D

Sensory defects in lower limbs

Develops worse over time with T2D and poor glycemic control

Question 5

Types of neuropathy

Answer 5

Sensory

Autonomic (dry skin, focal skin ischaemia)

Motor (wasting of foot muscle, clawing of toes)

Commonly all coexist

Question 6

PAD

Answer 6

Atherosclerosis in lower limb arteries

Atherosclerosis common in nearly everyone with T2D

Question 7

PAD treatments

Answer 7

Difficult due to calcification

Revascularisation is attempted but may not be possible due to long calcified areas

Question 8

Arteries below knee

Answer 8

Tibioperoneal trunk (TPT)
Anterior tibial artery (ATA)
Posterior tibial artery (PTA)
Peroneal artery (PA)

Question 9

Options to treat PAD

Answer 9

Balloon angioplasty / stent

Bypass- May be hard due to no outflow vessel

Question 10

Management of diabetic foot

Answer 10

MDT

Offloading

Treat infections

Diabetic foot sepsis is medical emergency and requires infected tissue to be removed

Question 11

Why is wound left open after surgery

Answer 11

Encourage healing and draining to prevent abscess