Detection, management, and prevention of diabetes-related foot disease in the Australian context

Abstract

Diabetes-related foot disease (DFD) is a widely feared complication among people who live with diabetes. In Australia and globally, rates of disability, cardio-vascular disease, lower extremity amputation, and mortality are significantly increased in patients with DFD. In order to understand and prevent these outcomes, we analyse the common pathogenetic processes of neuropathy, arterial disease, and infection. The review then summarises important management considerations through the interdisciplinary lens. Using Australian and international guidelines, we offer a stepwise, evidence-based practical approach to the care of patients with DFD.

Keywords: Diabetes-related foot disease; Foot ulceration; Lower extremity amputation; Neuropathy; Peripheral arterial disease; Infection

Core Tip: In Australia, the interdisciplinary service is recognised as a critical component of providing care to people with diabetes-related foot disease (DFD). We give our perspective on the management of DFD based on 6 categories: (1) Assessment and education in high-risk patients; (2) Wound preparation, debridement, and dressing; (3) Offloading and footwear; (4) Diagnosis and management of infection; (5) Interventions including revascularisation, pharmacotherapy, and novel wound therapies; and (6) Integrated interdisciplinary care and patient information.