Ulkus Diabetikum Pedis Dextra: Laporan Kasus
Downloads
Diabetes Mellitus (DM) is a chronic metabolic disease with increased blood glucose levels due to impaired insulin secretion or work. According to the International Diabetes Federation (2021), there are around 537 million people with DM in the world, and the number continues to rise. One of the serious complications is diabetic foot ulcers, which are chronic lesions on the feet due to peripheral neuropathy, ischemia, and infection. This paper discusses the case of a 47-year-old woman with a diabetic ulcer after being hit by a motorcycle exhaust. The wound is enlarged, purulent, swollen, and accompanied by severe pain. 7-year history of DM with Blood Sugar At 632 mg/dL and HbA1C 13.6%. Management includes antibiotics, insulin drip, insulin sliding scale, and debridement when blood sugar is <200 mg/dL. Diabetic foot ulcers arise as a result of a combination of neuropathy, ischemia, and infections exacerbated by chronic hyperglycemia. Minor wounds can become severe infections when glucose control is poor. Assessment of severity uses Wagner's classification and degree of infection to determine therapy. Treatment requires a multidisciplinary approach, including blood sugar control, antibiotic therapy, wound care, and debridement. Prevention through education, glucose control, and regular foot care is important to reduce the risk of complications and amputations.
American Diabetes Association. (2018). 2. Classification and diagnosis of diabetes: Standards of medical care in diabetes—2018. Diabetes Care, 41(Suppl 1), S13–S27. https://pubmed.ncbi.nlm.nih.gov/29222373/
American Diabetes Association. (2023). Standards of medical care in diabetes—2023. Diabetes Care, 46(Suppl 1), S1–S291.
Armstrong, D. G., Boulton, A. J., & Bus, S. A. (2017). Diabetic foot ulcers and their recurrence. The New England Journal of Medicine, 376(24), 2367–2375. https://doi.org/10.1056/NEJMra1615439
Armstrong, D. G., Tan, T. W., Boulton, A. J., & Bus, S. A. (2023). Diabetic foot ulcers: A review. JAMA, 330(1), 62–75. https://doi.org/10.1001/jama.2023.8221
Cortes-Penfield, N. W., Armstrong, D. G., Brennan, M. B., et al. (2023). IWGDF/IDSA guidelines on the diagnosis and treatment of diabetes-related foot infections (IWGDF/IDSA 2023). Clinical Infectious Diseases, 77(1), e1–e13. https://doi.org/10.1093/cid/ciad077
Del Core, M. A., Ahn, J., Lewis, R. B., Raspovic, K. M., Lalli, T. A., & Wukich, D. K. (2018). The evaluation and treatment of diabetic foot ulcers and diabetic foot infections. Foot & Ankle Orthopaedics, 3(3), 2473011418788862. https://doi.org/10.1177/2473011418788862
Frykberg, R. G., & Banks, J. (2016). Management of diabetic foot ulcers: A review. Federal Practitioner, 33(2), 16–23.
Gariani, K., Uçkay, I., & Lipsky, B. A. (2014). Managing diabetic foot infections: A review of the new guidelines. Acta Chirurgica Belgica, 114(1), 7–16. https://doi.org/10.1080/00015458.2014.11680993
International Diabetes Federation. (2021). IDF diabetes atlas (10th ed.). https://diabetesatlas.org
International Working Group on the Diabetic Foot (IWGDF). (2023). Guidelines on the prevention and management of diabetic foot disease.
Levy, N., & Gillibrand, W. (2019). Management of diabetic foot ulcers in the community: An update. British Journal of Community Nursing, 24(Sup3), S14–S19. https://doi.org/10.12968/bjcn.2019.24.Sup3.S14
Lipsky, B. A., Berendt, A. R., Cornia, P. B., Pile, J. C., Peters, E. J. G., Armstrong, D. G., ... Warren, S. (2012). 2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections. Clinical Infectious Diseases, 54(12), e132–e173. https://doi.org/10.1093/cid/cis346
Lipsky, B. A., Senneville, É., Laouri, M., et al. (2020). Guidelines on the diagnosis and treatment of foot infection in persons with diabetes. Clinical Infectious Diseases, 70(6), e284–e312. https://doi.org/10.1093/cid/ciz959
Maity, S., Leton, N., Nayak, N., Jha, A., Anand, N., Thompson, K., et al. (2024). A systematic review of diabetic foot infections: Pathogenesis, diagnosis, and management strategies. Frontiers in Clinical Diabetes and Healthcare, 5, 1393309. https://doi.org/10.3389/fcdhc.2024.1393309
McDermott, K., Fang, M., Boulton, A. J., Selvin, E., & Hicks, C. W. (2023). Etiology, epidemiology, and disparities in the burden of diabetic foot ulcers. Diabetes Care, 46(1), 209–221. https://doi.org/10.2337/dc22-1464
Parveen, K., Hussain, M. A., Anwar, S., Elagib, H. M., & Kausar, M. A. (2025). Comprehensive review on diabetic foot ulcers and neuropathy: Treatment, prevention and management. World Journal of Diabetes, 16(3), 100329. https://doi.org/10.4239/wjd.v16.i3.100329
Perkeni. (2021). Pedoman pengelolaan dan pencegahan diabetes melitus tipe 2 di Indonesia. Jakarta: Perkumpulan Endokrinologi Indonesia.
Ramirez-Acuña, J. M., Cardenas-Cadena, S. A., Marquez-Salas, P. A., et al. (2019). Diabetic foot ulcers: Current advances in antimicrobial therapies and emerging treatments. Antibiotics, 8(4), 193. https://doi.org/10.3390/antibiotics8040193
Wagner, F. W. (1981). The dysvascular foot: A system for diagnosis and treatment. Foot & Ankle, 2(2), 64–122. https://doi.org/10.1177/107110078100200202
Zhang, P., Lu, J., Jing, Y., Tang, S., Zhu, D., & Bi, Y. (2017). Global epidemiology of diabetic foot ulceration: A systematic review and meta-analysis. Annals of Medicine, 49(2), 106–116. https://doi.org/10.1080/07853890.2016.1231932
Copyright (c) 2025 Lensy Khosinatus Syarifah, Nugroho Budi Santoso, Linda Armelia
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-ShareAlike 4.0 International (CC-BY-SA). that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
