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Call for better diabetic foot management

A consensus published this month in Diabetic Medicine aims to help people with diabetes who are presently at low-risk of foot complications to undertake a basic foot care regimen in order to reduce their likelihood of developing serious foot complications in the future.

The consensus was developed by 10 UK-based global thought leaders to provide a practical educational framework for all healthcare professionals managing patients with diabetes.

Information about foot health and foot self-care for people with diabetes who are at low risk of diabetes-related foot complications is currently very limited. In response the consensus recommends the implementation of a four step CARE programme to improve the management of foot health:

  • Control: maintaining good blood glucose levels (in accordance with recommendations from the healthcare professional)
  • Annual: attending an annual foot screening examination with healthcare professionals
  • Report: reporting any changes in sensation, skin colour, breaks in the skin, swelling or pain immediately to healthcare professionals
  • Engage: undertaking a simple daily foot care routine by washing and drying between the toes, moisturising and checking for abnormalities.

“The consensus should become a guide for healthcare professionals to help communicate the importance of basic foot self-care to all people with diabetes, particularly those currently at low-risk of foot complications” comments consensus author, Alistair McInnes, University of Brighton, UK.

“Basic foot care is simple, quick and empowers the patient to manage their foot health more proactively, and can help reduce the likelihood of complications later on.”

Healthcare professionals need guidance on how best to educate and support people with diabetes to undertake foot self-care, and it is important that people with diabetes are able to manage their foot health from an early stage to reduce the risk of foot complications in the future.

People with diabetes presently in this low-risk group can develop serious foot complications relatively quickly in the absence of good glycaemic control and regular foot self-care, which can facilitate the prompt identification of changes in the feet. Diabetes can lead to the feet becoming prone to complications and at risk of ulceration as a result of peripheral neuropathy (nerve damage) and circulatory problems.

Foot complications have a significant impact on healthcare systems across the world and are responsible for more hospital bed days than all the other diabetic complications combined.

In the UK alone, the cost of foot disease is estimated to be 20% of the total cost of managing diabetes, and may exceed £1bn each year. Each week around 100 people lose a leg because of diabetes.