Peripheral arterial disease: diagnosis and management. Updated 2016, International Working Group on the Diabetic Foot guidance on the prevention of foot ulcers in at-risk patients with diabetes 2015, National Institute for Health and Care Excellence. Diabetic foot problems: prevention and management. The guideline development group selected recommendations from the National Institute for Health and Care Excellence clinical guideline 19. The group included representation from rural and urban India, and public and private sectors. 33 A multidisciplinary guideline development group consisting of surgeons, primary care practitioners, and a patient representative developed these guidelines, with inputs from experts in diabetes, diabetic foot rehabilitation, and vascular surgery.
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This clinical update is based on recommendations in the standard treatment guideline, The diabetic foot: prevention and management in India 2016, published by the Indian Ministry of Health and Family Welfare. 5 We provide an update on the prevention and initial management of diabetic foot in primary care.
4 Most amputations start with ulcers and can be prevented with good foot care and screening to assess the risk for foot complications. 3 Between 0.03% and 1.5% of patients with diabetic foot require an amputation.
2 It can impair patients’ quality of life and affect social participation and livelihood. Refer patients with foot ulceration and signs of infection, sepsis, or ischaemia immediately to a specialised diabetic foot centre for surgical care, revascularisation, and rehabilitationįoot disease affects nearly 6% of people with diabetes 1 and includes infection, ulceration, or destruction of tissues of the foot. Diabetic foot can be prevented with good glycaemic control, regular foot assessment, appropriate footwear, patient education, and early referral for pre-ulcerative lesionsĮxamine the feet of people with diabetes for any lesions and screen for peripheral neuropathy and peripheral arterial disease, which can lead to injuries or ulceration
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