The treatment of diabetic ulceration is multi-disciplinary. Prevention is better than cure. Prevention requires the identification of feet 'at risk' ideally in dedicated foot clinics. Patients can be educated and advised on appropriate foot care. Such an approach has been shown to reduce amputation rates.
Neuropathic ulcers require pressure relief and debridement of callus.
Ischaemic ulcers require vascular assessment often including angiographic assessment down to the pedal vessels. Revascularisation often involves a distal bypass procedure. Recent papers Donnelly R, Emslie-Smith A M, Gardner I D, Morris A D. Vascular complications of diabetes. Tomas M B, Patel M, Marwin S E, Palestro C J. Diabetic foot.