Clinical Practice Recommendations on the Diabetic Foot 2017


#1

Foot problems in people with diabetes are a global problem and there is no area in the world that does not report the development of foot lesions as a consequence mainly of neuropathy and peripheral arterial disease. The diabetic foot is a major medical, social and economic problem worldwide. However, the reported frequency of ulceration and amputation varies considerably. This may be due to differences in diagnostic criteria, treatment options, and the presence of qualified health professionals, as well as regionally specific social, economic and health-related factors.

The goal of these IDF Guidelines is to protect the diabetic foot from breakdown, preventing foot ulceration and lower limb amputations, by taking preventative measures early in the disease process and treating the foot in the early Risk Categories of 1, and 2 and before they become the very high Risk Category 3.

Comprehensive diabetic foot assessments and foot care, based on prevention, education and a multi-disciplinary team approach, may reduce foot complications and amputations by up to 85%. Foot assessments should include at the minimum checking for sensation and pulses and looking for foot deformities. Proper foot assessments and timely referral and management can reduce risk for ulceration and possible amputation.

These guidelines are not only for the specialists in diabetic foot but to everyone with an interest in the management of the diabetic foot. We hope that by using the guidelines those looking after people with diabetes will be better informed and give better care to those with diabetes and will result in less ulcers and fewer amputations.


#2

It would be great to stimulate discussion with all the members. So I have two questions:

How did everyone find our simplified, easy to digest guidelines? Was there any sections that anyone has questions or concerns on or needs further clarification?

Also, how comfortable is everyone in diagnosing a Stage 0 and Stage 1 Charcot Foot? We had a patient in the office a few months ago that was a bilateral Charcot foot Stage 1!