الفهرس 
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Abstract
Introduction Diabetic foot is defined by WHO as an infection, ulceration and/or destruction of deep tissues associated with neurological abnormalities and/or peripheral vascular disease in the lower limb.(Amin N et al.,2016),also it is defined byDutch consensusasvariety of foot abnormalities caused by neuropathy, macro-angiopathy, restricted joint mobility and other consequences of metabolic disorder, mostly occurring in combination, in patients with diabetes mellitus.(Amin N et al.,2016) Diabetic foot is considered one of the most serious complications of diabetes. It is considered to be the leading cause of hospital admissions, lower limb amputation and mortality in patients with diabetes worldwide(Costa et al., 2017a). Proper identification of foot at risk of ulceration and amputation and ideal treatment of these conditions by multidisciplinary team will decrease complication. (Hinchliffe et al., 2016a). Many devastating impact on excellence of life in patient and their families could be made by foot ulcers and amputation of lower limb. (Gerrits et al., 2015).Management of foot at risk for ulceration and amputation have considerable economic burden on health services (Hingorani et al., 2016). Epidemiology : Diabetic foot is one of the most serious complication of diabetes as is diplays the highest numbers of hospital admissions among diabetics. diabetic foot disease has been focused by IDF 2005 a one of the most srerious consequences of diabtes.it was also noted that with progression of age,the incidence of lower extremity amputation in diabetic patient Introduction 2 increases.(Boulton et al., 2005). It is noted that about15% of diabetics will experience in their life a foot ulcer , and also about 25-50% of diabetic patients receive immediate amputation at the time of the first visit due to the infection. And as a result, diabetes considered the leading cause of non-traumatic amputation of the lower limb, with a risk in diabetic patients 15 times higher than
non-diabetics. (Leone et al., 2012) Many difficulties in providing care for diabetics is due to Difficulty of access to continuing medical education for physicians, especially in emerging countries exhibiting high prevalence (Leone et al., 2012). Another annoying matter is the propagation of incorrect beliefs regarding treatment of DM (for example, insulin being linked to blindness) and wound healing (for example the inappropriate use of honey, spider webs, gelatin, herbal preparations, as cures) that finally increase percentage of
amputation among diabetics . (Rebolledo et al., 2011) Many programs considered to encourage understanding and prevent and diabetic foot complications . As a result, the rate of amputations dropped nearly by the half of the patient . (Li et al., 2010) Physicians can apply better prevention programs by identifying risk factors for foot ulceration which in turn lead to diminishing the economic load for both patient and health care system. (Al-Rubeaan et al., 2015) Bolton and his colleguereported many risk factors for DFUs such as Deformity, Peripheral arterial disease, Neuropathy, Previous amputation, History of previous wound and Obesity. (Boulton, 2006). As observed by costa and his collegue, largest number of lower limb amputation result from diabetic neuropathy peripheral vascular disease, foot bone deformities, and external trauma. (Costa et al., 2017a).