Pathophysiology and pathogenesis of diabetic foot syndrome [Pathophysiologie und pathogenese des diabetischen fußsyndroms]

As is known, the target set in the St. Vincent Declaration to reduce the rate of amputations by 50% in Europe was largely missed. It still holds true that "the majority of amputations could be prevented by correct differential diagnosis, appropriate differential therapy and suitable prophylaxis" (Ernst Chantelau). Most amputations are preceded by a foot lesion. These first develop due to an arrangement and the interaction of a series of risk components. These include besides the diabetes itself the diabetic sequelae and other factors. Their interaction leads to lesions and initiates processes that often result in an amputation with all its fateful and economic consequences. It is prerequisite for correct differential diagnosis and thus adequate differential therapy that risk factors are identified in detail and their individual role in a foot lesion assessed. Recognising the risks in a person with diabetes makes it ultimately possible to develop strategies for an individualised programme for prevention and to implement them. © Springer Medizin Verlag 2005.