Skin Necrosis of the Diabetic Foot and Its Management

The global prevalence of diabetes mellitus has risen by 16% in the last 2 years (DM) and is expected to continue this trajectory. Indeed, it is estimated to affect 537 million people in 2021, with this figure expected to rise to 643 million by 2030 and 783 million by 2045 [1]. Diabetes is primarily caused by the body’s inability to produce or respond to insulin, resulting in carbohydrate metabolic dysfunction [1]. Chronic insulin resistance can raise blood and urine glucose levels [1]. Diabetes patients are more likely to develop other systemic pathologies that can affect the feet, eyes, skin, kidneys, and cardiovascular systems. Because of the harmful nature of this disease process, it is a major risk factor for atherosclerotic disease. Peripheral artery disease (PAD) is a type of occlusive disease that typically affects the lower extremities. PAD is now thought to affect approximately 12 million people in the United States. Patients with PAD are more likely to have lower extremity amputations, and it can be an early warning sign of other harmful cardiovascular pathologies. Most of these amputations begin with diabetic foot ulcers [2]. A patient with a diabetic foot ulcer has a 2.5 times higher risk of death at 5 years than a patient with diabetes who does not have a foot ulcer. Infection occurs in more than half of diabetic ulcers. Approximately 20% of moderate or severe diabetic foot infections result in amputation. Peripheral artery disease raises the risk of nonhealing ulcers, infection, and amputation on its own [3].