Other Risk Factors

• Callus formation is the result of both increased plantar pressure and dry skin. The presence of callus is associated with a 77-fold increase in foot ulceration risk in patients with neuropathy. Regular removal of callosities results in a significant reduction in foot pressure and in prevention of ulceration [59].

• The presence of foot deformities (claw toes, prominent metatarsal heads, hallux valgus, nail deformities) is associated with an increased risk of foot ulceration.

• The presence of other microvascular complications, increased duration of diabetes, high plantar pressures, peripheral oedema, postural instability due to periph

Diabetes mellitus

Fig. 8.1.2 Pathways to foot ulceration in diabetic patients. From Boulton AJM (2000) The pathway to ulceration: aetiopathogenesis. In: Boulton AJM, Connor H, Cavanagh PR (eds) The foot in diabetes, 3rd edn. Wiley, Chichester, p 21, with permission) [9]

eral neuropathy, living alone or in nursery care facilities, negative attitude to foot care and refusal to adopt preventive foot care actions have all been associated with increased risk for foot ulceration.

• The most predictive factor, however, for foot ulceration is a previous history of ulceration or amputation. Indeed, in many diabetic foot clinics more than 50% of patients with new foot ulcers have a past history of similar problems [10].

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Diabetes 2

Diabetes 2

Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...

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