What is the pathophysiology of diabetic foot ulcers?

Updated: Oct 15, 2020
  • Author: Tanzim Khan, DPM; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Atherosclerosis and peripheral neuropathy occur with increased frequency in persons with diabetes mellitus (DM).

Trophic changes

Non-enzymatic glycosylation of skin and connective tissue, along with decreased collagen production in people with diabetes, result in alterations in the biomechanics in the diabetic foot. This is frequently seen in the Achilles tendon, where increased stiffness results in a contracture that limits ankle dorsiflexion, a condition known as equinus. Equinus has been associated with diabetic foot ulcers, as it increases plantar pressures in the forefoot and midfoot.

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