Diabetic Foot Ulcer: A Historical Overview

Abstract

This chapter reviews the historical discoveries and the evolution of medical practices in the management of diabetic foot ulcers (DFUs). The knowledge acquired by ancient civilizations such as Babylon, China, Egypt, and India was further developed by the Greeks and Romans, who made significant improvements in foot amputations. The Arabs preserved and expanded these records, making them accessible to scientists during the European Renaissance. It was not until the early twentieth century that a better understanding of the complex etiological factors of DFUs began to emerge. A turning moment in the history of DFUs occurred in 1921 with the discovery of insulin, which effectively divided the timeline into two distinct periods: pre-insulin and post-insulin. While the role of revascularization in treating ischemic DFUs was established in the 1950s and 1960s, the importance of offloading was recognized in the 1970s and 1980s. Recently, the focus of DFU management has shifted to prevention, and multidisciplinary care involving podiatrists, nurses, endocrinologists, surgeons, and infectious disease specialists. Through the utilization of advanced technology and innovative therapies, we are now closer than ever to a future where DFUs will no longer pose a threat to patients’ health.