Katoulis E C, Boulton A J, Raptis S A
University Dept. of Medicine, Manchester Royal Infirmary, UK.
Horm Metab Res. 1996 Apr;28(4):159-64. doi: 10.1055/s-2007-979152.
Diabetic foot ulceration is currently a serious medical problem and has, therefore, attracted much research attention during the last two decades. Previous foot ulceration, diabetic neuropathy, limited joint mobility, high plantar pressures, microangiopathy, macroangiopathy and diabetic nephropathy have already been identified as risk factors for future foot ulceration. Neuropathy has clearly been shown to be an essential permissive factor in the development of ulceration in the non-ischaemic foot. Moreover, the pathogenetic role of high plantar pressures is crucial in the presence of established clinical neuropathy. Nowadays, our therapeutic efforts clearly aim to prevent than treat foot ulcers. This demands specialist and team work in the setting up of a diabetic foot clinic in an attempt to identify and educate the diabetic patients at risk and, where possible to use suitable plantar pressure-reducing systems (footwear, hosiery etc.). Then only would it be reasonable to postulate that a significant reduction in amputations of diabetic aetiology could be achieved in the near future.
糖尿病足溃疡目前是一个严重的医学问题，因此在过去二十年中受到了很多研究关注。既往足部溃疡、糖尿病神经病变、关节活动受限、足底压力过高、微血管病变、大血管病变和糖尿病肾病已被确认为未来足部溃疡的危险因素。神经病变已明确被证明是非缺血性足部溃疡发生发展的一个必要的促成因素。此外，在已确诊临床神经病变的情况下，足底压力过高的致病作用至关重要。如今，我们的治疗努力显然旨在预防而非治疗足部溃疡。这需要在设立糖尿病足诊所时进行专科和团队协作，以识别和教育有风险的糖尿病患者，并在可能的情况下使用合适的减轻足底压力的系统（鞋类、袜子等）。只有这样，才有可能推测在不久的将来糖尿病病因导致的截肢显著减少。
