Pathogenesis (development of disease)
Causally, ischemia (reduced blood flow), neuropathy (generic term for diseases of the peripheral nerves that do not have a traumatic cause), and infection (in this case, concomitant infection) play a central role. Furthermore, hyperglycemic status (hyperglycemia) plays a role in inducing a disturbance of the wound healing cascade.
Approximately 50% of diabetic foot cases are due to neuropathic (due to nerve damage) lesions, up to 35% neuropathic-ischemic lesions (diabetic neuropathy) and approximately 15% are due to ischemic (due to circulatory disturbances; diabetic angiopathy) lesions.
Diabetic foot is jointly caused by the factors mentioned below.
Etiology (causes)
Biographic causes
- Socioeconomic factors
- Low social status/low level of education.
- Poor access to services of the health care system
Behavioral causes
- Unsuitable footwear (pressure points).
- Walking barefoot
- Objects in the shoes
- Lack of / inadequate training
- Lack of compliance
Disease-related causes
Eyes and ocular appendages (H00-H59).
- Impaired vision, unspecified.
Endocrine, nutritional, and metabolic diseases (E00-E90).
- Diabetes mellitus (diabetes), especially with poor blood glucose control → hyperglycemia (hyperglycemia).
- Diabetic neuropathy – nerve damage caused by diabetes mellitus.
- Pre-existing ulcerations (ulcerations).
Skin and subcutaneous (L00-L99)
- Corneal calluses
Cardiovascular system (I00-I99)
- Peripheral arterial occlusive disease (pAVD) – progressive narrowing or occlusion of the arteries supplying the arms/ (more commonly) legs, usually due to atherosclerosis (arteriosclerosis, hardening of the arteries).
Infectious and parasitic diseases (A00-B99).
- Onychomycosis (nail fungus) of the foot.
Musculoskeletal system and connective tissue (M00-M99).
- Limited joint mobility, unspecified.
- Foot deformities, unspecified
- Bony prominences, unspecified
Other causes
- Fall/accident
