Practical guidelines on the prevention and management of diabetes-related foot disease (IWGDF 2023 update).

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Nicolaas C Schaper, Jaap J van Netten, Jan Apelqvist, Sicco A Bus, Robert Fitridge, Fran Game, Matilde Monteiro-Soares, Eric Senneville, IWGDF Editorial Board

Author Information

Nicolaas C Schaper: Division Endocrinology, MUMC+, CARIM and CAPHRI Institute, Maastricht, The Netherlands.
Jaap J van Netten: Department of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. ORCID
Jan Apelqvist: Department of Endocrinology, University Hospital of Malmö, Malmö, Sweden.
Sicco A Bus: Department of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. ORCID
Robert Fitridge: Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia.
Fran Game: Department of Diabetes and Endocrinology, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK. ORCID
Matilde Monteiro-Soares: Portuguese Red Cross School of Health - Lisbon, Lisbon, Portugal. ORCID
Eric Senneville: Department of Infectious Diseases Gustave Dron Hospital, Tourcoing; Univ-lille, Lille, France. ORCID

PMID: 37243927 DOI: 10.1002/dmrr.3657

Diabetes-related foot disease results in a major global burden for patients and the healthcare system. The International Working Group on the Diabetic Foot (IWGDF) has been producing evidence-based guidelines on the prevention and management of diabetes-related foot disease since 1999. In 2023, all IWGDF Guidelines have been updated based on systematic reviews of the literature and formulation of recommendations by multidisciplinary experts from all over the world. In addition, a new guideline on acute Charcot neuro-osteoarthropathy was created. In this document, the IWGDF Practical Guidelines, we describe the basic principles of prevention, classification and management of diabetes-related foot disease based on the seven IWGDF Guidelines. We also describe the organisational levels to successfully prevent and treat diabetes-related foot disease according to these principles and provide addenda to assist with foot screening. The information in these practical guidelines is aimed at the global community of healthcare professionals who are involved in the care of persons with diabetes. Many studies around the world support our belief that implementing these prevention and management principles is associated with a decrease in the frequency of diabetes-related lower-extremity amputations. The burden of foot disease and amputations is increasing at a rapid rate, and comparatively more so in middle to lower income countries. These guidelines also assist in defining standards of prevention and care in these countries. In conclusion, we hope that these updated practical guidelines continue to serve as a reference document to aid healthcare providers in reducing the global burden of diabetes-related foot disease.

IWGDF daily practice diabetic foot foot ulcer guidelines implementation

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Monteiro-Soares M, Hamilton EJ, Russell DA, et al. Guidelines on the classification of foot ulcers in people with diabetes (IWGDF 2023 update). Diab Metab Res Rev. 2023. https://doi.org/10.1002/dmrr.36487

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Lazzarini PA, Armstrong DG, Crews RT, et al. Effectiveness of offloading interventions for people with diabetes-related foot ulcers: a systematic review and meta-analysis. Diab Metab Res Rev. 2023. Forthcoming.

Chuter VH, Schaper NC, Mills JL, et al. Effectiveness of bedside investigations to diagnose peripheral artery disease among people with diabetes mellitus: a systematic review. Diab Metab Res Rev. 2023. Forthcoming.

Chuter VH, Schaper NC, Mills JL, et al. Performance of prognostic markers in the prediction of wound healing or amputation among patients with foot ulcers in diabetes: a systematic review. Diab Metab Res Rev. 2023. Forthcoming.

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Raspovic KM, Schaper NC, Gooday C, et al. Diagnosis and treatment of active charcot neuro-osteoarthropathy in persons with diabetes mellitus: a systematic review. Diab Metab Res Rev. 2023. Forthcoming.

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Humans

Diabetic Foot

Foot Diseases

International Agencies

Amputation, Surgical

Diabetes Mellitus

Journal Article

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