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The Geriatric Diabetic Foot

The prevalence of diabetic foot disease, a multifactorial syndrome which can lead to severe complications including limb amputation, is increasing among elderly patients. The most important causal factor is diabetic neuropathy. Though the pathophysiology does not differ from younger patients, geriatric diabetics tend to have a higher prevalence of neuropathy, peripheral arterial disease and foot deformity with a higher risk of amputation. Management of chronic diabetic foot ulcers should be centered on vascularity, infection, pressure injury and source of healing, customizing the treatment strategy to each patient’s individual condition and environment. The best management is preemptive, preventing the exacerbation of causal factors through glycemic control, management of hypertension and dyslipidemia, and cessation of smoking, combined with careful daily foot care including pressure relief and checking for minor injuries.