MANAGEMENT AROUND THE WORLD EXPERT SURGEON’S POINT OF VIEW

Diabetes mellitus (DM) is a chronic disease that affects worldwide in a prevalence of 4 to 6,5%. There is a negative social and economical impact due to the complex multiple-organ system involvement with diabetes. Over 40% of diabetic patients develop renal insuffi ciency. Diabetic patients present 2 to 6 times cardiopathies than a non diabetic person and have the risk increased by 2 to 4 times developing a vascular cerebral disease. The heterogeneous nature of diabetes produces the variable course of diabetic foot disease. Presence of sensory alterations and non corrected deformities are the principal risk factor on development of complications. Approximately 25% of hospital admissions in diabetic individuals are directly related to foot problems. Diabetes mellitus is the leading cause of nontraumatic lower extremity amputations, and require amputation 15 to 40 times than a non diabetic patient.