Introduction
Diabetes mellitus (DM) is a group of metabolic diseases marked by hyperglycemia that primarily endangers human health in the twenty-first century. Type 2 Diabetes Mellitus (T2DM) is caused by defects in insulin secretion, insulin action, or both, and accounts for 90-95% of all types of diabetes. According to data on the incidence of diabetes mellitus, 537 million adults (20-79 years) have diabetes; this figure is expected to rise to 643 million by 2030 and 783 million by 2045 [1]. According to Riskesdas 2018, the prevalence of diabetes mellitus in Indonesia in 2007 was 5.7 percent, then rose to 6.9% in 2013, and then rose again to 8.5% in 2018 [2].
The most serious complication of diabetes mellitus is Diabetic Foot Ulcer (DFU). DFU occurs in diabetic patients, accounting for nearly 25% of all diabetic patients [3–5]. During the course of the disease, DFU accounts for 14 to 24% of lower extremity amputations [6]. DFU develops as a result of peripheral neuropathy, ischemia, and neuro-ischemia. The loss of protective sensation and muscle coordination in the feet caused by neuropathy affects mechanical stresses during ambulation [7, 8]. Furthermore, the decreased oxygen supply in the lower limb causes ischemia and can result in a wound.
DFU can be caused by a combination of ischemia and neuropathy, both of which deteriorate the patient's skin integrity. DFU is a DM complication that can be treated. Appropriate dietary, activity, and therapy changes can all have an impact on DFU healing. DFU will heal at a rate of 60-80%. However, 10-15% will remain germinate, and 5-24% will have an amputation within 6-18 months