Diabetic foot: strategies for prevention

Approximately 50% of non-traumatic amputations of the lower limbs are realized among diabetes mellitus patients. Amputations are preceded by ulcers, characterized by skin erosion and loss of the epithelium, which can expand to the dermis or reach profound tissues, accompanied by insensibility due to chronic peripheral neuropathy, associated with small traumas as a result of inappropriate footwear, common dermatoses or incorrect foot manipulation. This study aims to describe the main findings and strategies to evaluate risk factors that lead to the development of lower limb complications among diabetes patients and make them part of the primary health care team's responsibilities. This literature review emphasizes evaluation of the feet and visible skin parts as a basic prevention measure, with a view to the early identification of neuropathic and peripheral vascular changes and biomechanical dysfunctions. The evaluation of footwear characteristics is highlighted as an external factor.

Diabetes mellitus; Risk factors; Diabetic foot

Escola Paulista de Enfermagem, Universidade Federal de São Paulo R. Napoleão de Barros, 754, 04024-002 São Paulo - SP/Brasil, Tel./Fax: (55 11) 5576 4430 - São Paulo - SP - Brazil
E-mail: ape@unifesp.br