Diabetic Foot: Evaluation, Non-surgical Assessment and Surgical Management

India has been called the diabetic capital of the world. Managing diabetic foot disease requires careful attention to properly diagnosing the condition and then determining what surgical interventions are required. Evaluation of diabetic foot disease includes risk factor identification, history and physical examination. Non-surgical assessment includes both subjective and objective measures of peripheral nerve functions like symptoms, signs, inspection, palpation, musculoskeletal examination, pain score by visual analogue scale, pin prick test, monofilament test, temperature perception test, vibration perception test, proprioception test, assessment of tone, power and deep tendon reflex, capillary refill time assessment, pedal pulses examination, vascular doppler study for ankle brachial index, toe brachial index, doppler waveform assessment and infrared thermometry. Surgical management includes various dressing methods, nerve decompression surgery, nerve transfer surgery, skin grafting and local flaps. Patients should be counselled regarding appropriate footwear and pressure garments.