# Pathophysiology of Diabetic Foot for Nurses | Bobr.ai
> Learn the mechanisms of diabetic foot disease, including neuropathy, angiopathy, and Charcot foot, with clinical screening tools and patient education tips.

Tags: diabetic-foot, pathophysiology, nursing-education, diabetes-complications, neuropathy, podiatry, clinical-screening, healthcare
## Pathophysiology of Diabetic Foot
* Overview of how diabetes affects the feet, presented by Jawaher Almaskari, Podiatrist.

## What is Diabetic Foot Disease?
* **Stats:** 15–25% lifetime risk of foot ulcer; 50–70% recurrence rate within 5 years.
* **Impact:** Up to 85% of amputations are preceded by a foot ulcer.

## 4 Main Pathophysiological Mechanisms
1. **Metabolic Dysfunction:** Hyperglycemia damaging nerves and vessels.
2. **Neuropathy:** Loss of feeling, weakness, and dry skin.
3. **Angiopathy:** Poor circulation and atherosclerosis.
4. **Immune Impairment:** Reduced ability to fight infections.

## Diabetic Neuropathy Explained
* **Sensory:** Loss of protective sensation leading to unnoticed injuries.
* **Motor:** Muscle weakness leading to deformities like claw toes.
* **Autonomic:** Loss of sweating leading to dry, cracked skin.
* Neuropathy causes over 60% of diabetic foot ulcers.

## Diabetic Angiopathy (Poor Blood Flow)
* Hyperglycemia leads to atherosclerosis and narrowed arteries.
* PAD is present in ~50% of diabetic foot ulcers.
* Signs include absent pulses, cold feet, and cyanotic appearance.

## The Pathway to Ulceration
* Pathway: Neuropathy → Pressure/Deformity → Callus → Subcutaneous Bleeding → Foot Ulcer.
* Key factor: Patients often feel no pain, making inspection critical.

## Diabetic Foot Infections
* Common bacteria: *Staphylococcus aureus*; MRSA in up to 30% of cases.
* Risk of Osteomyelitis (bone infection).
* Diabetic foot infection is considered a medical emergency.

## Charcot Foot
* Progressive bone and joint destruction.
* **Sign:** A hot, red, swollen foot in a patient with neuropathy (midfoot collapse/rocker-bottom deformity).

## Risk Stratification (IWGDF)
* **Risk 0:** Very low (Annual check).
* **Risk 1:** Low (6-12 month check).
* **Risk 2:** Moderate (3-6 month check).
* **Risk 3:** High (1-3 month check).

## Nurse's Screening Checklist
* **Look for:** Color, temperature, callus, deformities, and nail health.
* **Test:** 10g monofilament test for sensation and pulse checks (Dorsalis pedis/Posterior tibial).

## Patient Education & Key Takeaways
* Daily foot inspection and washing (water < 37&deg;C).
* Never walk barefoot; wear properly fitting shoes.
* Early detection and referral to podiatry can prevent amputation.
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