What is the primary cause of foot disease in diabetic patients?

• A. Sensory neuropathy, ischemia, and infection.
• B. Hypertension alone.
• C. Obesity without other factors.
• D. Visual impairment.

Answer: (A)

Foot disease in diabetes is driven by a combination of three interrelated problems: sensory neuropathy, ischemia, and infection. Sensory neuropathy causes loss of protective sensation, so minor injuries or blisters go unnoticed and can worsen into ulcers. Ischemia from peripheral arterial disease reduces blood flow, making wounds harder to heal and more susceptible to tissue death. Infection exploits even small breaks in the skin and thrives in the high-glucose environment, accelerating tissue damage. Together, neuropathy lets injuries occur and persist, ischemia impairs healing, and infection drives progression—this triad is what most strongly underlies diabetic foot disease. Hypertension, obesity, or visual impairment can contribute to risk, but they are not the primary mechanisms by which foot ulcers and infections develop in diabetes.