Managing complications of the diabetic foot

#### Summary points Fifteen per cent of patients with diabetes will develop a foot ulcer in their lifetime. Foot complications (box 1) account for more hospital admissions than any other complication of diabetes, with considerable morbidity and mortality.1 People with diabetes are eight to 24 times more likely than those without diabetes to have a lower limb amputated.2 Around 85% of these amputations could be avoided by early detection of foot complications, timely intervention, involvement of a diabetic foot care team, good diabetes control, and patient education.3 4 Although we review the various complications separately, patients often have multiple problems. #### Sources and selection criteria We searched Medline and PubMed from 1995 to 2009, focusing on evidence based publications on the diabetic foot and randomised trials for treatment of diabetic foot complications. We supplement these sources with our own knowledge of the literature and selected reviews. #### Box 1 Foot complications in diabetes5 In 1989 the St Vincent Declaration set out the aim of reducing lower limb amputations …