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Volume 351:1694-1695 October 14, 2004 Number 16
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Neuropathic Diabetic Foot Ulcers

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by Boulton, A. J.M.
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To the Editor: Boulton et al. (July 1 issue)1 state that foot ulceration in diabetes is caused by several factors acting together, but particularly by neuropathy. They also assert that direct evidence of a link between glycemic control and healing of neuropathic ulcers is lacking. However, there is good evidence that glycemic control delays the progression of neuropathy.2 I am surprised that glucose control or normalization is not specifically advocated. Furthermore, the American Diabetes Association and others recommend normalization of blood glucose levels as an important component of the prevention and treatment of diabetic foot wounds.3,4,5


Hernan R. Chang, M.D.
. . . [Full Text of this Article]



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