A 67-year-old man with diabetes presenting with a foot ulcer
Summary: This CMAJ case discusses a 67-year-old man with diabetes presenting with a foot ulcer. Key management principles include prompt offloading using a nonremovable knee-high device (e.g., total contact cast or nonremovable walker), assessment for infection and ischemia, glycemic optimization, and referral to a foot specialist (podiatrist, wound care nurse, or chiropodist). The article emphasizes daily foot checks, pressure offloading to reduce mechanical stress, and multidisciplinary care to prevent progression and complications such as amputation. It serves as a practical primer aligning with evidence-based diabetic foot guidelines.
Key Highlights:
- Offloading is cornerstone: prefer nonremovable knee-high total contact cast or walker
- Assess for infection, peripheral artery disease, and neuropathy
- Refer early to podiatry or wound care specialist; daily foot inspection advised
- Emphasizes prevention of recurrence in high-risk diabetic patients
Keywords: diabetic foot ulcer case, total contact cast, offloading, diabetic foot management