Diabetic foot problems: prevention and management

Research recommendations coming out of this guidance

• Intensive monitoring for people at risk of diabetic foot problems:- Does intensive monitoring of people at risk of diabetic foot disease reduce the morbidity associated with developing the disease and is such monitoring cost effective?

• Does intensive monitoring of people at risk of diabetic foot disease reduce the morbidity associated with developing the disease and is such monitoring cost effective?

• What is the clinical effectiveness of maggot debridement therapy in the debridement of diabetic foot ulcers?

• Which risk stratification tools can be used to predict the likelihood of Charcot arthropathy?

• When is it safe to stop contact casting in the treatment of acute Charcot arthropathy?

• Referral criteria for the foot protection service and the multidisciplinary foot care service:- When and with what criteria should people with diabetes be referred to the foot protection service or the multidisciplinary foot care service?

• When and with what criteria should people with diabetes be referred to the foot protection service or the multidisciplinary foot care service?

• When and with what criteria should people with diabetes be referred to the foot protection service or the multidisciplinary foot care service?

• Education and psycho-behavioural interventions for prevention:- What is the role of educational models and psycho-behavioural interventions in prevention of diabetic foot complications?

• What is the role of educational models and psycho-behavioural interventions in prevention of diabetic foot complications?

• Prevention strategies for Charcot arthropathy:- What strategies may be useful in the prevention of Charcot arthropathy?

• What strategies may be useful in the prevention of Charcot arthropathy?

• Diabetic ulcer dressings:- What is the clinical effectiveness of different dressing types in treating diabetic foot problems?

• What is the clinical effectiveness of different dressing types in treating diabetic foot problems?

• Within the hospital multidisciplinary team, when is it appropriate and effective to refer people with diabetes who have foot problems to specialist services such as investigative or interventional radiology, orthopaedic or vascular services, specialist pain management and specialist orthotics?

• What is the effectiveness of different footwear, insoles and orthoses in the prevention of foot problems?

• How often should people with diabetic foot problems (foot ulcers, soft tissue infections, osteomyelitis or gangrene) be reviewed?

• What is the clinical effectiveness of negative pressure wound therapy in the treatment of diabetic foot ulcers?