A multidisciplinary foot care team approach can lower the incidence of diabetic foot ulcers and amputation: Results of the asti study at 12 years [Un approccio di cura multidisciplinare al piede diabetico può ridurre l'incidenza di ulcere e amputazioni: Risultati dello studio di asti a 12 anni]
De Corrado G.,SOC Malattie Metaboliche |
Repetti E.,SOC Malattie Metaboliche |
Latina A.,SOC Malattie Metaboliche |
Viglione P.,SOC Malattie Metaboliche |
And 8 more authors.
Giornale Italiano di Diabetologia e Metabolismo | Year: 2013
Foot ulcers and lower extremity amputation (LEA) are common among diabetic patients but can be prevented. Approximately 15% of these patients have a foot ulcer some time in their life. In most cases - in some studies about 85% - the ulcers are followed by non-traumatic diabetic amputations. These lay a heavy burden on individuals with diabetes, the health care system and society. The risk of diabetic foot ulcers and amputation could be substantially reduced by multidisciplinary assistance programs (MAPs), as suggested by the International Consensus Con - ference of the International Working Group on the Diabetic Foot (IWGDF). Previous studies in specialized (3rd level) centers have reported the efficacy of team care for the prevention and treatment of the diabetic foot but few long-term studies have evaluated the strength of the team strategy in smaller centers. In the Asti Diabetic Unit (2nd level) we implemented the recommendations of the IWGDF consensus document, to set up MAPs to engage patients in foot care, primary and secondary prevention. The 3rd level centers provide essential support for more complex interventions. In this prospective observational study, we examined whether the implementation of MAPs, as suggested by the IWGDF, lowered the incidence of foot ulcers and amputations. We recorded the main clinical features of the study population and the number of foot ulcers, and minor and major LEAs. In the 12 years since the unit was set up we have observed 1244 foot ulcers (mean prevalence 16%) in 905 diabetic patients (11.7% of all patients in the unit). The incidence of foot ulcers, minor and major LEAs has dropped significantly. A MAP for the diabetic foot in a 2nd level center involved in care, primary and secondary prevention, as suggested by the IWGDF Consensus document, could help reduce the long-term incidence of foot ulcers and LEAs.