Bekaryssova Dana, Yessirkepov Marlen, Rakisheva Ak-Uke, Bakytzhan Assylkhan
Department of Project Management, South Kazakhstan Medical Academy, Shymkent, Kazakhstan.
Center for Life and Health Sciences, National Academy of Sciences under the President of the Republic of Kazakhstan, Almaty, Kazakhstan.
Rheumatol Int. 2025 May 2;45(5):132. doi: 10.1007/s00296-025-05890-8.
Diabetic foot is a frequent and debilitating complication of diabetes mellitus that significantly impairs quality of life and increases the risk of disability and amputation. This review examines the multifactorial pathogenesis of diabetic foot, focusing on its increased incidence and severity in patients with rheumatic diseases. The development of diabetic foot is driven by diabetic neuropathy, peripheral vascular disease, and infection. In patients with rheumatic diseases, chronic systemic inflammation and vascular dysfunction further accelerate tissue damage and impair wound healing. Long-term use of pharmacologic agents such as glucocorticoids and nonsteroidal anti-inflammatory drugs also contributes to metabolic imbalance, immune suppression, and vascular complications, increasing the risk of ulceration and infection. Rheumatic disease-related joint deformities and altered foot biomechanics add mechanical stress, exacerbating the condition. Effective management of diabetic foot in patients with rheumatic diseases requires a multidisciplinary approach. This includes early diagnosis, strict glycemic control, modulation of systemic inflammation, optimization of vascular health, and preventive foot care strategies. Addressing both metabolic and rheumatologic components is essential to reduce the risk of severe outcomes such as chronic infection and limb amputation. Understanding the interplay between diabetes and rheumatic diseases is crucial for improving clinical outcomes. Targeted, integrated interventions are key to preventing complications and enhancing the quality of life for affected patients.
糖尿病足是糖尿病常见且使人衰弱的并发症，严重损害生活质量，增加残疾和截肢风险。本综述探讨糖尿病足的多因素发病机制，重点关注其在风湿性疾病患者中发病率和严重程度的增加。糖尿病足的发生由糖尿病神经病变、外周血管疾病和感染驱动。在风湿性疾病患者中，慢性全身炎症和血管功能障碍会进一步加速组织损伤并损害伤口愈合。长期使用糖皮质激素和非甾体抗炎药等药物也会导致代谢失衡、免疫抑制和血管并发症，增加溃疡和感染风险。风湿性疾病相关的关节畸形和足部生物力学改变会增加机械应力，使病情恶化。对风湿性疾病患者的糖尿病足进行有效管理需要多学科方法。这包括早期诊断、严格控制血糖、调节全身炎症、优化血管健康以及预防性足部护理策略。解决代谢和风湿因素对于降低慢性感染和肢体截肢等严重后果的风险至关重要。了解糖尿病与风湿性疾病之间的相互作用对于改善临床结局至关重要。有针对性的综合干预是预防并发症和提高受影响患者生活质量的关键。
