Which of the following comorbidities represent the greatest risk for the development of foot ulcers in a diabetic client? Select all that apply

Question

A) Bilateral distal loss of pain sensation
B) Previous incidents of diabetic ketoacidosis with blood glucose levels of 400 mg/dL
C) Diabetic renal problems with severely decreased GFR
D) Motor neuropathy related to improperly fitted shoes
E) Smoking history averaging 2 packs/day

Answer 1

Ans: A, D, E
Feedback:
Distal symmetric neuropathy is a major risk factor for foot ulcers due to the fact that people with sensory neuropathies have impaired pain sensation. Motor neuropathy with weakness of the intrinsic muscles of the foot may result in foot deformities, which lead to focal areas of high pressure. When the abnormal focus of pressure is coupled with loss of sensation, a foot ulcer can occur. Smoking should be avoided because it causes vasoconstriction and contributes to vascular disease. This risk factor supersedes that posed by nephropathy or DKA, although each problem suggests that the client's diabetes is inadequately controlled.