Vnitr Lek 2026, 72(5):E21-E26 | DOI: 10.36290/vnl.2026.063

Diabetic foot: from antibiotics to offloading and revascularization

Jana Pecová

II. interní klinika FN u sv. Anny, Brno

Diabetic foot syndrome (DFS, diabetic foot) is one of the late complications of diabetes mellitus. The WHO defines DFS as damage of the tissues of the foot distal to the ankle, most commonly associated with diabetic neuropathy and varying degrees of lower limb ischemia. (5) The clinical manifestations of DFS include ulcers, gangrene, and Charcot neuropathic osteoarthropathy (CNO). DFS is characterized by the heterogeneity of clinical findings. Patient care is multidisciplinary. It encompasses regular preventive education of patients on self-care of the feet, treatment of ulcers, administration of antibiotics in cases of foot infection, treatment of osteomyelitis, surgical management of the foot (incision, drainage, necrectomy, preservative low amputations of the forefoot/midfoot). Essential are offloading and attempts at revascularization in cases of ischemia. In most diabetics over the past decades, complex pharmacological treatment has long preceded the onset of DFS symptoms. The impaired ulcer healing process is further contributed to by pressure loading of the foot, which, by the very nature of foot function, seems to be difficult to eliminate.

Keywords: angiopathy, antibiotics, Charcot neuropathic osteoarthropathy, diabetic polyneuropathy, infection, offloading, revascularization, diabetic foot syndrome, ulceration.

Accepted: August 20, 2026; Published: August 27, 2026  Show citation