Abstract
Introduction
Diabetes is one of the most prevalent chronic diseases. It is estimated that the annual Population based incidence of a diabetic foot ulcer ranges from 1.0 % to 4.1 %. The lifetime Incidence may be as high as 25%. 85% of Diabetes related amputations are preceded by foot ulcers, and it accounts for more than half of non-traumatic lower limb amputations. The vascular insufficiency and neuropathy accompanying the diabetic foot most often necessitate amputation of the limb. Diabetic foot is classified into 2 main types: NPU (neuropathic ulcer) and NIU (neuro-ischaemic ulcer). In NIU, PVD is also present in addition to neuropathy. Differentiation between NPU and NIU is important because they require different therapeutic strategies and their prognosis is different. Prevalence of PVD has been shown to be higher among patients with DM as compared to age and sex matched non diabetics. Neuropathy is a major contributing risk factor for foot ulcers and can involve both somatic and autonomic fibres. The myelinated (A-type) sensory fibres are associated with proprioception, sensation of light touch, pressure, and vibration, and motor innervations of the muscle spindles. Neuropathy of the A-type nerve fibre results in ataxic gait and intrinsic weakness of the foot muscles.
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Corresponding Author
Dr Bilal Pathan
Department of Medicine, MGM Medical College, Navi Mumbai
DOI: https://dx.doi.org/10.18535/jmscr/v6i2.109
